Form PTO/SB/107 Declaration for Utility or Design Patent Application - R

PTO/SB/107 (S-!jG)
Appra1led for use IIV'OuQh 9/30/98 0MB 0651-0032
Palenl and Trademarl< Olfooe: U.S. DEPARTMENT OF COMMERCE
Under 1he PapefWOl1< Reduetion ,a of 1996. no persons ""'niquted to respon" to a coaectooo of information unleSS lt displays a valid OM8 c:onro1 oomber.

Declaration and Power of Attorney for Patent Application
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Russian Language Declaration
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As a below named inventor, I hereby declare that:

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I believe I am the original, first and sole inventor (if only one
name is listed below) or an original, ftrst and joint inventor (If
plural nalllf".S are listed below) of the subject matter which is
c:iaimed and for which a patent is sought on the invention
1mtitled

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the specification of which is attached hereto unless the
following box is checked:

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I hereby state that I have reviewed and understand the contents
c>f the above identified specification, including the claims, as
amended by any amendment referred to above.

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was filed on __________
as United States Application Number or PCT
International Application Number
______ and was amended on
_____ (if applicable).

II hereby claim foreign priority under Title 35, United States Code,

§ 119(a)•(d} or§ 365(b) of any foreign application(s) to< patent or

iinventor's certificate, or§ 365(a) of any PCT International
,application which designated at least one country other than the
!United States. listed below and have also identified below, by
,::hecidng the box, any foreign application for patent or inventor's
,i:ertificate, or PCT International application having a filing date
lbefore that of the application on which priority is claimed.

Page I of 4
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OMB Clearance and PRA Burden Statement for PTO/SB/107
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