Form Pto/sb/59 - Request For Supplemental Examination Transmittal Page 2
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Patent No.
PTO/SB/59 (09-16)
Approved for use through 09/30/2018. OMB 0651-0064
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.
10.
A legible copy of each item of information listed in Part B of this form, and an English language translation of all necessary
and pertinent parts of each non-English language item of information are included.
Copies of items of information that form part of the discussion within the body of the request (see 37 CFR 1.605(b)), and
copies of U.S. patents and patent application publications, are not required. 37 CFR 1.610(b)(7).
11.
A summary of the relevant portions of each non-patent document that is over 50 pages in length (other than the request) is
included. The summary includes the required citations to the particular pages containing the relevant portions. 37 CFR
1.610(b)(8).
12.
A separate, detailed explanation of the relevance and manner of applying each item of information to each claim of the
patent for which supplemental examination is requested, is included. 37 CFR 1.610(b)(5).
13.
The below list includes all prior or concurrent post-patent Office proceedings (ex parte or inter partes reexamination, reissue,
supplemental examination, post grant review, or inter partes review) involving the patent for which supplemental examination
is being requested. 37 CFR 1.610(b)(3). An identifying number may be, e.g., a control no. or reissue application no. Any
prior or concurrent post-patent Office proceedings not listed below are listed on a separate paper accompanying the request.
Type of Proceeding
Identifying Number
Filing Date
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
See accompanying paper for a list of additional prior or concurrent post-patent Office proceedings involving the patent for
which supplemental examination is requested. The paper should be a separate sheet titled “List of Prior or Concurrent Post-
Patent Office Proceedings” and must provide the type, identifying number, and filing date of the post-patent Office proceeding.
14. Correspondence Address: Please recognize, or change, the correspondence address for the file of the patent for which
supplemental examination is requested and for the supplemental examination proceeding to be:
The address associated with Customer Number:
OR
Firm or
Individual Name
Address
City
State
Zip
Country
Telephone
Email
15. WARNING: Information on this form may become public. Credit card information should not be included on this form.
Provide credit card information and authorization on PTO-2038.
_________________________________________________
___________________________
Authorized Signature
Date
__________________________________________________
___________________________
Typed/Printed Name
Registration No.
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