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PTO/SB/02A (07-07)
Approvato per l’uso fino al XX/XX/XXX. OMB 0651-0032
Approved for use through XX/XX/XXXX. OMB 0651-0032
Ufficio Brevetti e Marchi depositati USA; MINISTERO DEL COMMERCIO USA
U.S. Patent and Trademark Office; U.S. DEPARTMENT OF COMMERCE
In rispetto del Paperwork Reduction Act del 1995, nessuno è obbligato a rispondere a informazionia meno che non contengano un numero di controllo OMB valido.
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.

ULTERIORI INVENTORI
ADDITIONAL INVENTOR(S)

DICHIARAZIONE
DECLARATION

Foglio supplementare
Supplemental Sheet

Nome di eventuali ulteriori Co-Inventori:
Name of Additional Joint Inventor, if any:

Pagina
Page

È stata presentata un’istanza per questo inventore senza firma
A petition has been filed for this unsigned inventor

Nome (primo e secondo (se usato))
Given Name (first and middle (if any))

Cognome
Family Name or Surname

Firma dell’Inventore
Inventor’s Signature
Residenza: Città
Residence: City

di
of

Data
Date
Nazione
Country

Provincia
State

Cittadinanza
Citizenship

Indirizzo
Mailing Address
Città
City

Provincia
State

Nome di eventuali ulteriori Co-Inventori:
Name of Additional Joint Inventor, if any:

CAP
Zip

È stata presentata un’istanza per questo inventore senza firma
A petition has been filed for this unsigned inventor

Nome (primo e secondo (se usato))
Given Name (first and middle (if any))

Cognome
Family Name or Surname

Firma dell’Inventore
Inventor’s Signature
Residenza: Città
Residence: City

Nazione
Country

Data
Date
Provincia
State

Nazione
Country

Cittadinanza
Citizenship

Indirizzo
Mailing Address
Città
City

Provincia
State

Nome di eventuali ulteriori Co-Inventori:
Name of Additional Joint Inventor, if any:
Nome (primo e secondo (se usato))
Given Name (first and middle (if any))

CAP
Zip

È stata presentata un’istanza per questo inventore senza firma
A petition has been filed for this unsigned inventor
Cognome
Family Name or Surname

Firma dell’inventore
Inventor’s Signature
Residenza: Città
Residence: City

Nazione
Country

Data
Date
Provincia
State

Nazione
Country

Cittadinanza
Citizenship

Indirizzo
Mailing Address
Città
City

Provincia
State

CAP
Zip

Nazione
Country

Le pr esenti i nformazioni sono r ichieste dag li atti 35 U .S.C. 115 e 37 C FR 1.63. Le i nformazioni sono nec essarie per ottener e o ritenere u n b eneficio da l p ubblico p er a rchiviare (e d all’
USPTO per esaminare) una domanda. La riservatezza è regolata dall’atto 35 U.S.C. 122 e 37 CFR 1.11 e 1.14. La compilazione richiede circa 21 minuti, compreso il tempo che occorre per
raccogliere, preparare e i nviare il modulo di domanda completo a USPTO. La q uantità di tempovaria di caso in caso. I nviare ev entuali comm enti su l tem po necessario p er compilare il
modulo e/o suggerimenti per ridurre il carico a Chief Information Officer, U.S. Patent and Trademark Office, U.S. Department of Commerce, P.O. Box 1450, Alexandria, VA 22313-1450. NON
INVIARE PAGAMENTI O I MODULI COMPLETATI A QUESTO INDIRIZZO. INVIARLI A: 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 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.

Se si ha bisogno di assistenza per compilare questo modulo, chiamare il numero 1-800-PTO-9199 (1-800-786-9199) e selezionare l’opzione 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)
Approvato per l’uso fino al XX/XX/XXXX. OMB 0651-0032
Approved for use through XX/XX/XXXX OMB 0651-0032
Ufficio Brevetti e Marchi depositati USA; MINISTERO DEL COMMERCIO USA
U.S. Patent and Trademark Office; U.S. DEPARTMENT OF COMMERCE
In rispetto del Paperwork Reduction Act del 1995, nessuno è obbligato a rispondere a informazioni a meno che non contengano un numero di controllo OMB valido.
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.

DICHIARAZIONE – Foglio dati prioritari supplementare
DECLARATION – Supplemental Priority Data Sheet
Domande straniere:
Foreign applications:
Numero (Numeri) domande straniere
precedenti
Prior Foreign Application Number(s)

Nazione
Country

Data di compilazione straniera
Foreign Filing Date
(MM/GG/AAAA)
(MM/DD/YYYY)

Priorità non richiesta
Priority Not Claimed

Allegata copia autenticata?
Certified Copy Attached?
SÌ NO
YES NO

Le pr esenti i nformazioni sono r ichieste dag li atti 35 U .S.C. 115 e 37 C FR 1.63. Le i nformazioni sono nec essarie per ottener e o ritenere u n b eneficio da l p ubblico p er a rchiviare (e d all’
USPTO per esaminare) una domanda. La riservatezza è regolata dall’atto 35 U.S.C. 122 e 37 CFR 1.11 e 1.14. La compilazione richiede circa 21 minuti, compreso il tempo che occorre per
raccogliere, preparare e i nviare il modulo di domanda completo a U SPTO. La quantità di tempo varia di caso in caso. Inviare eventuali comm enti sul tempo necessario per compilare i l
modulo e/o suggerimenti per ridurre il carico a Chief Information Officer, U.S. Patent and Trademark Office, U.S. Department of Commerce, P.O. Box 1450, Alexandria, VA 22313-1450. NON
INVIARE PAGAMENTI O I MODULI COMPLETATI A QUESTO INDIRIZZO. INVIARLI A: 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 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.

Se si ha bisogno di assistenza per compilare questo modulo, chiamare il numero 1-800-PTO-9199 (1-800-786-9199) e selezionare l’opzione 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