Declaration (Additional Inventors) and Supplemental Priority Data Sheets (German Language)

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PTO/SB/02A (07-07)
Zur Verwendung genehmigt bis einschl. XX/XX/XXXX. OMB 0651-0032
Approved for use through XX/XX/XXXX. OMB 0651-0032
US-amerikanisches Patent- und Markenamt; US-HANDELSMINISTERIUM
U.S. Patent and Trademark Office; U.S. DEPARTMENT OF COMMERCE
Gemäß Gesetz zur Vermeidung unnötiger Formulare von 1995 ist niemand verpflichtet, auf ein Informationspaket zu antworten, es sei denn, es enthält eine gültige OMB-Kontrollnummer.
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.

WEITERE(R) ERFINDER
ADDITIONAL INVENTOR(S)

ERKLÄRUNG
DECLARATION

Zusatzblatt
Supplemental Sheet

Name des zusätzlichen gemeinsamen
Erfinders, sofern zutreffend:
Name of Additional Joint Inventor, if any:

Seite
Page

Für diesen Erfinder, der nicht unterzeichnet hat, wurde ein Antrag
gestellt
A petition has been filed for this unsigned inventor

Vorname (erster und zweiter Vorname, sofern zutreffend)
Given Name (first and middle (if any))

Familienname oder Nachname
Family Name or Surname

Unterschrift des Erfinders
Inventor’s Signature
Wohnort: Stadt
Residence: City

von
of

Datum
Date
Bundesland
State

Land
Country

Staatsbürgerschaft
Citizenship

Straße u. Hausnr.
Mailing Address
Stadt
City

Bundesland
State

Name des zusätzlichen gemeinsamen
Erfinders, sofern zutreffend:
Name of Additional Joint Inventor, if any:

Postleitzahl
Zip

Für diesen Erfinder, der nicht unterzeichnet hat, wurde ein Antrag
gestellt
A petition has been filed for this unsigned inventor

Vorname (erster und zweiter Vorname, sofern zutreffend)
Given Name (first and middle (if any))

Familienname oder Nachname
Family Name or Surname

Unterschrift des Erfinders
Inventor’s Signature
Wohnort: Stadt
Residence: City

Land
Country

Datum
Date
Bundesland
State

Land
Country

Staatsbürgerschaft
Citizenship

Straße u. Hausnr.
Mailing Address
Stadt
City

Bundesland
State

Name des zusätzlichen gemeinsamen
Erfinders, sofern zutreffend:
Name of Additional Joint Inventor, if any:

Postleitzahl
Zip

Für diesen Erfinder, der nicht unterzeichnet hat, wurde ein Antrag
gestellt
A petition has been filed for this unsigned inventor

Vorname (erster und zweiter Vorname, sofern zutreffend)
Given Name (first and middle (if any))

Familienname oder Nachname
Family Name or Surname

Unterschrift des Erfinders
Inventor’s Signature
Wohnort: Stadt
Residence: City

Land
Country

Datum
Date
Bundesland
State

Land
Country

Staatsbürgerschaft
Citizenship

Straße u. Hausnr.
Mailing Address
Stadt
City

Bundesland
State

Postleitzahl
Zip

Land
Country

Diese Informationen sind gemäß 35 U.S.C. 115 und 37 CFR 1.63 erforderlich. Diese Informationen sind erforderlich, um einen öffentlichen Vorteil zu erhalten oder beizubehalten, d. h. einen
Antrag z u stel len ( und di esen v om U S-amerikanischen P atent- u nd M arkenamt ( USPTO) bear beiten z u l assen). Ver traulichkeit g emäß 35 U .S.C. 1 22 und 37 C FR 1.1 1 und 1.14. D as
Ausfüllen dieses Informationspakets, d. h. das Sammeln, Vorbereiten und Einreichen des ausgefüllten Antrags beim USPTO, nimmt etwa 21 Minuten Zeit in Anspruch. Die Zeit hängt jeweils
vom individuellen Fall ab. K ommentare zu dem für das A usfüllen dieses Formulars erforderlichen Zeitaufwand und/oder Vorschläge zur Reduzierung dieses Vorgangs sollten an den Chief
Information O fficer, U .S. P atent and Trademark O ffice, U .S. D epartment of C ommerce, P.O. Box 14 50, Al exandria, VA 22313-1450, U SA, ge richtet w erden. KEINE GEB ÜHREN ODE R
AUSGEFÜLLTEN FORMULARE AN DIESE ADRESSE SENDEN. FORMULAR SENDEN AN: Commissioner for Patents, P.O. Box 1450, Alexandria, VA 22313-1450; USA.
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 b y the pu blic which is to file (an d by th e US PTO 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 Administrative 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.

Wenn Sie Hilfe beim Ausfüllen des Formulars benötigen, rufen Sie die Nummer 1-800-PTO-9199 (1-800-786-9199) an und wählen Option 2.
If you need assistance in completing the form, call 1-800-PTO-9199 (1-800-786-9199) and select option 2.

PTO/SB/02B (07-07)
Zur Verwendung genehmigt bis einschl. XX/XX/XXXX. OMB 0651-0032
Approved for use through XX/XX/XXXX. OMB 0651-0032
US-amerikanisches Patent- und Markenamt; US-HANDELSMINISTERIUM
U.S. Patent and Trademark Office; U.S. DEPARTMENT OF COMMERCE
Gemäß Gesetz zur Vermeidung unnötiger Formulare von 1995 ist niemand verpflichtet, auf ein Informationspaket zu antworten, es sei denn, es enthält eine gültige OMB-Kontrollnummer.
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.

ERKLÄRUNG - Zusätzliches Prioritäts-Datenblatt
DECLARATION – Supplemental Priority Data Sheet
Ausländische Anträge:
Foreign applications:
Vorherige ausländische
Antragsnummer(n)
Prior Foreign Application Number(s)

Land
Country

Ausländisches Antragsdatum
Foreign Filing Date
(MM/TT/JJJJ)
(MM/DD/YYYY)

Priorität nicht
beansprucht
Priority Not Claimed

Beglaubigte Kopie beigefügt?
Certified Copy Attached?
JA N
EIN
YES NO

Diese Informationen sind gemäß 35 U.S.C. 115 und 37 CFR 1.63 erforderlich. Diese Informationen sind erforderlich, um einen öffentlichen Vorteil zu erhalten oder beizubehalten, d. h. einen
Antrag zu stellen (und diesen vom US-amerikanischen Patent- und Markenamt (USPTO) zu bearbeiten). Vertraulichkeit gemäß 35 U.S.C. 122 und 37 CFR 1.11 und 1.14. Das Ausfüllen
dieses I nformationspakets, d . h . d as S ammeln, V orbereiten und Einreichen d es a usgefüllten Antrags b eim USPTO, nimmt etwa 21 M inuten Ze it i n A nspruch. Die Z eit hä ngt jew eils vom
individuellen Fal l ab. Kommentare z u dem für das Aus füllen di eses For mulars er forderlichen Zei taufwand un d/oder Vor schläge z ur Reduzierung di eses Vor gangs sol lten an d en C hief
Information O fficer, U .S. P atent and Trademark O ffice, U .S. D epartment of C ommerce, P.O. Box 14 50, Al exandria, VA 22313-1450, U SA, ge richtet w erden. KEINE GEB ÜHREN ODE R
AUSGEFÜLLTEN FORMULARE AN DIESE ADRESSE SENDEN. FORMULAR SENDEN AN: Commissioner for Patents, P.O. Box 1450, Alexandria, VA 22313-1450; USA.
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 b y the pu blic which is to file (an d by th e US PTO 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 Administrative 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.

Wenn Sie Hilfe beim Ausfüllen des Formulars benötigen, rufen Sie die Nummer 1-800-PTO-9199 (1-800-786-9199) an und wählen Option 2.
If you need assistance in completing the form, call 1-800-PTO-9199 (1-800-786-9199) and select option 2.

OMB Clearance and PRA Burden Statement for PTO/SB/02B
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 21 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