Form Pto/sb/59 - Request For Supplemental Examination Transmittal Page 3
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5PTO/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.
(Also referred to as FORM PTO-XXXX)
REQUEST FOR SUPPLEMENTAL EXAMINATION TRANSMITTAL FORM
PART B – LIST OF ITEMS OF INFORMATION – Page 1
Patent number for which supplemental examination is requested ___________________
Issue Date ______________
All items of information (no more than 12) submitted herewith as part of this request for supplemental
examination of the above-identified patent are included in the following list:
U. S. PATENT DOCUMENTS
Pages, Columns, Lines, Where
Cite
Document Number
Publication
Name of Patentee or
Relevant Passages or Relevant
No.
1
2 (if
Date
Applicant of Cited Document
Number-Kind Code
Figures Appear
known)
MM-DD-
YYYY
US-
US-
US-
US-
US-
US-
US-
US-
US-
US-
US-
US-
FOREIGN PATENT DOCUMENTS
Cite
Foreign Patent
Publication
Name of Patentee or
Pages, Columns, Lines, Where
No.
1
Document
Date
Applicant of Cited Document
Relevant Passages or
3
4
MM-DD-
Relevant Figures Appear
2
Country Code
-Number
-
T
Kind Code
5
(if known)
YYYY
1
Applicant’s unique citation designation number (optional).
2
See Kinds Codes of USPTO Patent Documents at or MPEP 901.04.
3
Enter Office that issued
the document, by the two-letter code (WIPO Standard ST.3).
4
For Japanese patent documents, the indication of the year of the reign of the Emperor must precede the serial
number of the patent document.
5
Kind of document by the appropriate symbols as indicated on the document under WIPO Standard ST.16 if possible.
6
Applicant is to place a
check mark here if English language Translation is attached.
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