PTOL 85 B Fee Transmittal

International Design Applications (Hague Agreement)

ptol85b

OMB: 0651-0075

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PART B – FEE(S) TRANSMITTAL
Complete and send this form, together with the applicable fee(s), by mail or fax, or via EFS-Web.
By mail, send to:
Mail Stop ISSUE FEE
Commissioner for Patents
P.O. Box 1450
Alexandria, VA 22313-1450

By fax, send to:

(571) 273-2885

INSTRUCTIONS: This form should be used for transmitting the ISSUE FEE and P UBLICATION FEE (if required). Blocks 1 through 5 should be completed where appropriate.
All further correspondence including the P atent, advance orders and notification of maintenance fees will be mailed to the current correspondence address as indicated unless
corrected below or directed otherwise in Block 1, by (a) specifying a new correspondence address; and/or (b) indicating a separate “ FEE ADDRESS” for maintenance fee
notifications.
CURRENT CORRESPONDENCE ADDRESS (Note: Use Block 1 for any change of address)

Note: A certificate of mailing can only be used for domestic mailings of the
Fee(s) Transmittal. This certificate cannot be used for any other accompanying
papers. Each additional paper, such as an assignment or formal drawing, must
have its own certificate of mailing or transmission.
Certif icate of Mailing or Transmission
I hereby certify that this Fee(s) Transmittal is being deposited with the United
States P ostal Service with sufficient postage for first class mail in an envelope
addressed to the Mail Stop ISSUE FEE address above, or being transmitted to the
USP TO via EFS-Web or by facsimile to (571) 273-2885, on the date below.
(Typed or printed name)
(Signature)
(Date)

APPLICATION NO

FILING DATE

FIRST NAMED INVENTOR

ATTORNEY DOCKET NO

CONFIRMATION NO

TITLE OF INVENTION:
APPLN. TYPE

ENTITY STATUS

ISSUE FEE DUE

EXAMINER

PREV. PAID ISSUE FEE

ART UNIT

1. Change of correspondence address or indication of “ Fee
Address” (37 CFR 1.363)
Change of correspondence address (or Change of
Correspondence Address form P TO/SB/122) attached.
“ Fee Address” indication (or “ Fee Address” Indication
form P TO/SB/47; Rev 03-09 or more recent)
attached. Use of a Customer Number is required.
3.

PUBLICATION FEE DUE

TOTAL FEE(S) DUE

DATE DUE

CLASS-SUBCLASS

2. For printing on the patent front page, list
(1) The names of up to 3 registered patent attorneyss
or agents OR, alternatively,

1.

(2) The name of a single firm (having as a member
a registered attorney or agent) and the names of
up to 2 registered patent attorneys or agents. If
no name is listed, no name will be printed.

2.
3.

ASSIGNEE NAME AND RESIDENCE DATA TO BE P RINTED ON THE P ATENT (print or type)
P LEASE NOTE: Unless an assignee is identified below, no assignee data will appear on the patent. If an assignee is identified below, the document must have been
previously recorded, or filed for recordation, as set forth in 37 CFR 3.11 and 37 CFR 3.81(a). Completion of this form is NOT a substitute for filing an assignment.
(A) NAME OF ASSIGNEE

(B) RESIDENCE: (CITY and STATE or COUNTRY)

P lease check the appropriate assignee category or categories (will not be printed on the patent):
4a. Fees Submitted:

Issue Fee

P ublication Fee (if required)

Individual

Corporation or other private group entity

Government

Advance Order - # of Copies __________

4b. Method of P ayment (Please first reapply any previously paid fee shown above):
Electronic P ayment via EFS-Web
Enclosed check
Non-electronic payment by credit card (Attach form P TO-2038)
The Director is hereby authorized to charge the required fee(s), any deficiency, or credit any overpayment to Deposit Account No. __________
5. Change of Entity Status (from status indicated above)
Applicant certifying micro entity status. See 37 CFR 1.29.

NOTE: Absent a valid Certification of Micro Entity Status (see forms P TO/SB/15A and 15B), issue fee
payment in the micro entity amount will not be accepted at the risk of application abandonment.

Applicant asserting small entity status. See 37 CFR 1.27.

NOTE: If the application was previously under micro entity status, checking this box will be taken as
a notification of loss of entitlement to micro entity status.

Applicant changing to regular undiscounted fee status.

NOTE: Checking this box will be taken as a notification of loss of entitlement to small or micro entity
status, as applicable.

NOTE: This form must be signed in accordance with 37 CFR 1.31 and 1.33. See 37 CFR 1.4 for signature requirements and certifications.
Authorized Signature

Date

Typed or printed name

Registration No.

P TOL-85 Part B (08-18) Approved for use through XX/XX/XXXX

OMB 0651-0075

U.S. P atent and Trademark Office; U.S. DEP ARTMENT OF COMMERCE

OMB Clearance and PRA Burden Statement for PTOL-85 Part B
This collection of information is required by 37 CFR 1.137. The information is required to obtain or retain a benefit by the public which is to file
(and by the USPTO to process) an application. Confidentiality is governed by 35 U.S.C. 122 and 37 CFR 1.11, 1.14 and 41.6. This form is estimated to
take 30 minutes to complete, including gathering, preparing, and submitting the completed form to the USPTO. Time will vary depending upon the
individual case. Any comments on the amount of time you require to complete this form and/or suggestions for reducing this burden, should be sent
to the Chief Administration Officer, U.S. Patent and Trademark Office, U.S. Department of Commerce, P.O. Box 1450, Alexandria, VA 22313-1450. DO
NOT SEND FEES OR COMPLETED FORMS TO THIS ADDRESS. SEND TO: Mail Stop Petition, Commissioner for Patents, P.O. Box 1450, Alexandria, VA
22313-1450.

Privacy Act Statement
The Privacy Act of 1974 (P.L. 93-579) requires that you be given certain information in connection with your submission of the attached form related
to a patent application or patent. The United States Patent and Trademark Office (USPTO) collects this information under authority of 5 CFR 339.205.
The information in this system of records is used to manage all records of applicant including name, citizenship, residence, post office address and
other information pertaining to the applicant's activities in connection with the invention for which a patent is sought. Statements containing various
kinds of information with respect to inventors who are deceased or incapacitated, or who are unavailable or unwilling to make application for patent.
The information obtain is protected from disclosure to third parties in accordance with the Privacy Act.
However, routine uses of this information may include disclosure to the following: to law enforcement and investigation in the event that the system
of records indicates a violation or potential violation of law; to a Federal, state, local, or international agency, in response to its request; to an agency,
organization, or individual for the purpose of performing audit or oversight operations as authorized by law; to non-federal personnel under contract
to the agency; to a court for adjudication and litigation; to the Department of Justice for Freedom of Information Act (FOIA) assistance; to members of
congress working on behalf of an individual; to the Office of Personnel Management (OPM) for personnel research purposes; to National Archives and
Records Administration for inspection of records; and to the Office of Management and Budget (OMB)for legislative coordination and clearance.
Failure to provide any part of the requested information may result in an inability to process requests for access and information. The applicable
Privacy Act System of Records Notice for this information is COMMERCE/PAT-TM-7 Patent Application Files, available at Federal Register /Vol. 78, No.
61 / Friday, March 29, 2013 /Notices 19243. https://www.govinfo.gov/content/pkg/FR-2013-03-29/pdf/2013-07341.pdf


File Typeapplication/pdf
AuthorTamayo, Raul
File Modified2020-11-25
File Created2018-08-16

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