PTO/SB/06 Patent Application Fee Determination Record (Substitute

Doc Code: WFEE

Document Description: Fee Worksheet (SB06)

PTO/SB/06 (01-25)
Approved for use through XX/XX/XXXX. OMB 0651-0032
U.S. Patent and Trademark Office; U.S. DEPARTMENT OF COMMERCE
Under the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number.

Application or Docket Number

PATENT APPLICATION FEE DETERMINATION RECORD
Substitute for Form PTO-875

APPLICATION AS FILED – PART I

FOR

LARGE ENTITY
MICRO ENTITY
SMALL ENTITY

(Column 1)
NUMBER FILED

(Column 2)
NUMBER EXTRA

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

BASIC FEE
(37 CFR 1.16(a), (b), or (c))
SEARCH FEE
(37 CFR 1.16(k), (i), or (m))
EXAMINATION FEE
(37 CFR 1.16(o), (p), or (q))
TOTAL CLAIMS
(37 CFR 1.16(i))
INDEPENDENT CLAIMS
(37 CFR 1.16(h))
APPLICATION SIZE FEE
(37 CFR 1.16(s))

RATE ($)

FEE ($)

minus 20 =

*

x

=

minus 3 =

*

x

=

If the specification and drawings exceed 100 sheets of
paper, the application size fee due is $450 ($180 for
small entity or $90 for micro entity) for each
additional 50 sheets or fraction thereof. See 35 U.S.C.
41(a)(1)(G) and 37 CFR 1.16(s).
MULTIPLE DEPENDENT CLAIM PRESENT (37 CFR 1.16(j))

N/A

* If the difference in column 1 is less than zero, enter “0” in column 2.

TOTAL

LARGE ENTITY

APPLICATION AS AMENDED – PART II

MICRO ENTITY

AMENDMENT A

SMALL ENTITY
(Column 1)
CLAIMS
REMAINING
AFTER
AMENDMENT
TOTAL
(37 CFR 1.16(i))

INDEPENDENT
(37 CFR 1.16(h))

(Column 2)
HIGHEST
NUMBER
PREVIOUSLY
PAID FOR

(Column 3)
PRESENT
EXTRA

ADDITIONAL
FEE ($)

RATE ($)

*

Minus

**

=

x

=

*

Minus

***

=

x

=

APPLICATION SIZE FEE (37 CFR 1.16(s))
FIRST PRESENTATION OF MULTIPLE DEPENDENT CLAIM (37 CFR 1.16(j))

N/A

AMENDMENT B

TOT!L !DD’L FEE
(Column 1)
CLAIMS
REMAINING
AFTER
AMENDMENT
TOTAL
(37 CFR 1.16(i))

INDEPENDENT
(37 CFR 1.16(h))

(Column 2)
HIGHEST
NUMBER
PREVIOUSLY
PAID FOR

(Column 3)
PRESENT
EXTRA

ADDITIONAL
FEE ($)

RATE ($)

*

Minus

**

=

x

=

*

Minus

***

=

x

=

APPLICATION SIZE FEE (37 CFR 1.16(s))
FIRST PRESENTATION OF MULTIPLE DEPENDENT CLAIM (37 CFR 1.16(j))

N/A
TOT!L !DD’L FEE

*
If the entry in column 1 is less than the entry in column 2, write “0” in column 3.
** If the “Highest Number Previously Paid For” IN THIS SP!CE is less than 20, enter “20”.
*** If the “Highest Number Previously Paid For” IN THIS SP!CE is less than 3, enter “3”.
The “Highest Number Previously Paid For” (Total or Independent) is the highest number found in the appropriate box in column 1.

A Federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure to comply with an
information collection subject to the requirements of the Paperwork Reduction Act of 1995, unless the information collection has a currently valid OMB Control
Number. The OMB Control Number for this information collection is 0651-0031. Public burden for this form is estimated to average 12 minutes per response,
including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing
the information collection. Send comments regarding this burden estimate or any other aspect of this information collection, including suggestions for
reducing this burden to the Chief Administrative Officer, United States Patent and Trademark Office, P.O. Box 1450, Alexandria, VA 22313-1450
or email [email protected]. DO NOT SEND FEES OR COMPLETED FORMS TO THIS ADDRESS. SEND TO: Commissioner for Patents, P.O. Box
1450, Alexandria, VA 22313-1450.
If you need assistance in completing the form, call 1-800-PTO-9199 and select option 2.

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 the information in this record under authority of 35 U.S.C. 2. The USPTO’s
system of records is used to manage all applicant and owner information including name, citizenship,
residence, post office address, and other information with respect to inventors and their legal representatives
pertaining to the applicant's/owner’s activities in connection with the invention for which a patent is sought or
has been granted. The applicable Privacy Act System of Records Notice for the information collected in this
form is COMMERCE/PAT-TM-7 Patent Application Files, available in the Federal Register at 78 FR 19243
(March 29, 2013). https://www.govinfo.gov/content/pkg/FR-2013-03-29/pdf/2013-07341.pdf
Routine uses of the information in this record may include disclosure to: 1) law enforcement, in the event that
the system of records indicates a violation or potential violation of law; 2) a Federal, state, local, or international
agency, in response to its request; 3) a contractor of the USPTO having need for the information in order to
perform a contract; 4) the Department of Justice for determination of whether the Freedom of Information Act
(FOIA) requires disclosure of the record; 5) a Member of Congress submitting a request involving an individual
to whom the record pertains, when the individual has requested the Member’s assistance with respect to the
subject matter of the record; 6) a court, magistrate, or administrative tribunal, in the course of presenting
evidence, including disclosures to opposing counsel in the course of settlement negotiations; 7) the
Administrator, General Services Administration (GSA), or their designee, during an inspection of records
conducted by GSA under authority of 44 U.S.C. 2904 and 2906, in accordance with the GSA regulations and
any other relevant (i.e., GSA or Commerce) directive, where such disclosure shall not be used to make
determinations about individuals; 8) another federal agency for purposes of National Security review (35 U.S.C.
181) and for review pursuant to the Atomic Energy Act (42 U.S.C. 218(c)); 9) the Office of Personnel
Management (OPM) for personnel research purposes; and 9) the Office of Management and Budget (OMB) for
legislative coordination and clearance.
If you do not furnish the information requested on this form, the USPTO may not be able to process and/or
examine your submission, which may result in termination of proceedings, abandonment of the application,
and/or expiration of the patent.

Additional Uses
Additional USPTO uses of the information in this record may include disclosure to: 1) the International Bureau
of the World Intellectual Property Organization, if the record is related to an international application filed under
the Patent Cooperation Treaty; 2) the public i) after publication of the application pursuant to 35 U.S.C. 122(b),
ii) after issuance of a patent pursuant to 35 U.S.C. 151, iii) if the record was filed in an application which
became abandoned or in which the proceedings were terminated and which application is referenced by either
a published application, an application open to public inspections, or an issued patent, or iv) without publication
of the application or patent under the specific circumstances provided for by 37 CFR 1.14(a)(1)(v)-(vii); and/or
3) the National Archives and Records Administration, for inspection of records.