been previously submitted.
Deposit Account No. ____________________________________________________:
Fees required under 37 CFR 1.16
Fees required under 37 CFR 1.17
Fees required under 37 CFR 1.18
(not to exceed 3 months) and the fee under 37 CFR 1.17(i) is enclosed.
[Prior application Attorney Docket Number will carry over to this CPA unless a new Attorney Docket Number has
been provided herein.]
address below
Signature
Name (Print/Type)
Date
Telephone Number
PTO/SB/29 (07‐14)
Approved for use through 04/30/2017. 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
6. Applicant asserts small entity status. See 37 CFR 1.27.
7. Applicant certifies micro entity status. See 37 CFR 1.29. Form PTO/SB/15A or B or equivalent must be enclosed or have
8. The Director is hereby authorized to credit overpayments or charge the following fees to
a.
b.
c.
9. A check in the amount of $____________________________ is enclosed.
10. Payment by credit card. Form PTO‐2038 is attached.
11. Applicant requests suspension of action under 37 CFR 1.103(b) for a period of ____________months
12. New Attorney Docket Number, if desired _____________________________________________
13. a. Receipt For Facsimile Transmitted CPA (PTO/SB/29A)
b. Return Receipt Postcard (Should be specifically itemized. See MPEP 503)
14. Other:
The prior application’s correspondence address will carry over to this CPA UNLESS a new correspondence address is provided
NOTE:
below.
15. NEW CORRESPONDENCE ADDRESS
The address associated
Or New correspondence
with Customer Number:
Name
Address
City
State
Country
Zip Code
Email
15. SIGNATURE OF APPLICANT, ATTORNEY, OR AGENT REQUIRED
Registration No. (Attorney/Agent)
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