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PTO(美国专利与商标局)/SB/02A（07-07）
PTO/SB/02A (07-07)
批准使用直至 2010 年 9 月 30 日，OMB（行政管理与预算局）0651-0032
Approved for use through 09/30/2010. OMB 0651-0032
美国专利与商标局，美国商务部
U.S. Patent and Trademark Office; U.S. DEPARTMENT OF COMMERCE
根据 1995 年削减书面工作法案，除非信息的收集包含有效的 OMB 控制码，否则任何人都可无需要对此信息收集做出反应
Under the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it contains a valid OMB control number.

其他发明人
ADDITIONAL INVENTOR(S)

声明
DECLARATION

追加纸张
Supplemental Sheet 共

页

第

页
Page

of

关于该未签名发明人的请求书已经提交

其他联合发明人姓名，如有:
Name of Additional Joint Inventor, if any:

A petition has been filed for this unsigned inventor

名 (第一名和中间名(如有))
Given Name (first and middle (if any))

姓
Family Name or Surname

发明人签名
Inventor’s Signature

日期
Date

居住地：城市
Residence: City

州
State

国家
Country

公民身份
Citizenship

邮寄地址
Mailing Address
城市
City

州
State

邮政编码
Zip

国家
Country

关于该未签名发明人的请求书已经提交
A petition has been filed for this unsigned inventor

其他联合发明人姓名，如有:
Name of Additional Joint Inventor, if any:
名 (第一名和中间名(如有))
Given Name (first and middle (if any))

姓
Family Name or Surname

发明人签名
Inventor’s Signature

日期
Date

居住地：城市
Residence: City

州
State

国家
Country

公民身份
Citizenship

邮寄地址
Mailing Address
城市
City

州
State

邮政编码
Zip

关于该未签名发明人的请求书已经提交
A petition has been filed for this unsigned inventor

其他联合发明人姓名，如有:
Name of Additional Joint Inventor, if any:
名 (第一名和中间名(如有))
Given Name (first and middle (if any))

姓
Family Name or Surname

发明人签名
Inventor’s Signature
居住地：城市
Residence: City

国家
Country

日期
Date
州
State

国家
Country

公民身份
Citizenship

邮寄地址
Mailing Address
城市
City

州
State

邮政编码
Zip

国家
Country

根据《美国法典（U.S.C.）》第 35 篇第 115 条和《联邦法规(CFR)》第 37 篇第 1.63 条规定收集以上信息。需要该信息为提交申请（并由美国专利与商标局处理）的公众获得或保持利益。保
密规定遵循《美国法典》第 35 篇第 122 条和《联邦法规》第 37 篇第 1.11 和第 1.14 条执行。本信息收集预计花 21 分钟完成，包括集中、准备和提交完成后的申请表给美国专利和商标局。根
据各案例情况，时间会有所变化。任何关于完成本表格所需时间的评论和/或减轻负担的建议都应寄给首席信息官，地址：U.S. Patent and Trademark Office, U.S. Department of Commerce,
P.O. Box 1450, Alexandria, VA 22313-1450。不要将费用或完成后的表格寄至本地址，费用和表格寄送地址：Commissioner for Patents, P.O. Box 1450, Alexandria, VA 22313-1450。
This collection of information is required by 35 U.S.C. 115 and 37 CFR 1.63. 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 and 1.14. This collection is estimated to take 21 minutes to complete, including gathering, preparing,
and submitting the completed application 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 Information 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: Commissioner for Patents, P.O. Box 1450, Alexandria, VA 22313-1450.

如果对于完成本表格需要帮助，请致电：1-800-PTO-9199 (1-800-786-9199)并选 2.
If you need assistance in completing the form, call 1-800-PTO-9199 (1-800-786-9199) and select option 2.

PTO(美国专利与商标局)/SB/02B (07-07)
PTO/SB/02B (07-07)
批准使用直至 2010 年 9 月 30 日，OMB（行政管理与预算局）0651-0032

Approved for use through 09/30/2010. OMB 0651-0032
美国专利与商标局，美国商务部

U.S. Patent and Trademark Office; U.S. DEPARTMENT OF COMMERCE
根据 1995 年削减书面工作法案，除非信息的收集包含有效的 OMB 控制码，否则任何人都可无需要对该信息收集做出反应.
Under the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it contains a valid OMB control number.
声明 – 追加的专利优先权数据页
DECLARATION – Supplemental Priority Data Sheet
国外申请:
Foreign applications:

在先国外申请号
Prior Foreign Application Number(s)

国家
Country

国外申请提交日
Foreign Filing Date
(月/日/年)
(MM/DD/YYYY)

附有经认证的副本?
Certified Copy Attached?
未要求优先权
Priority Not Claimed

是
YES

否
NO

根据《美国法典（U.S.C）》第 35 篇第 115 条和《联邦法规(CFR)》第 37 篇第 1.63 条规定收集以上信息。需要该信息为提交申请（并由美国专利与商标局处理）
的公众获得或保持利益。保密规定遵循《美国法典》第 35 篇第 122 条和《联邦法规》第 37 篇第 1.11 和第 1.14 条执行。本信息收集预计花 21 分钟完成，包括集
中、准备和提交完成后的申请表给美国专利和商标局。根据各案例情况，时间会有所变化。任何关于完成本表格所需时间的评论和/或减轻负担的建议都应寄给首席
信息官，地址：U.S. Patent and Trademark Office, U.S. Department of Commerce, P.O. Box 1450, Alexandria, VA 22313-1450。不要将费用或完成后的表格寄至
本地址，费用和表格寄送地址：Commissioner for Patents, P.O. Box 1450, Alexandria, VA 22313-1450。
This collection of information is required by 35 U.S.C. 115 and 37 CFR 1.63. 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 and 1.14. This collection is estimated to take 21
minutes to complete, including gathering, preparing, and submitting the completed application 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 Information
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: Commissioner for Patents, P.O. Box 1450, Alexandria, VA 22313-1450.

如果对于完成本表格需要帮助，请致电：1-800-PTO-9199 (1-800-786-9199)并选 2.
If you need assistance in completing the form, call 1-800-PTO-9199 (1-800-786-9199) and select option 2.