Form Pto/sb/45 - Maintenance Fee Transmittal Form

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Patent and Trademark Office

‐ OR –

Deposit Account No. _______________.

form. Provide credit card information and authorization on Form PTO‐2038.

See 37 CFR 1.363.

PTO/SB/45 (03‐13)

Approved for use through 07/31/2018. OMB 0651‐0016

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.

MAINTENANCE FEE TRANSMITTAL FORM

(Do not submit this form electronically via EFS‐Web)

Address to:

I hereby certify that this correspondence is being deposited with the United States Postal Service with

Director of the United States

sufficient postage as first class mail in an envelope addressed to “Director of the United States Patent

and Trademark Office, Attn: Maintenance Fee, 2051 Jamieson Avenue, Suite 300, Alexandria, VA 22314”

Attn: Maintenance Fee

2051 Jamieson Avenue, Suite 300

on ___________________________________________________________________________________

Alexandria, VA 22314

Signature _____________________________________________________________________________

Typed or printed name __________________________________________________________________

Fax to: 571‐273‐6500

Enclosed herewith is the payment of the maintenance fee(s) for the listed patent(s).

1. A check for the amount of $ _______________ for the full payment of the maintenance fee(s) and any necessary surcharge is enclosed.

2. Payment by credit card. Form PTO‐2038 is enclosed.

3. The Director is hereby authorized to charge $ _______________ to cover the payment of the fee(s) indicated below to

4. The Director is hereby authorized to charge any deficiency in the payment of the required fee(s) or credit any overpayment to

Item

Patent

U.S. Application

Maintenance

Surcharge

Payment Year

Number*

Fee Amount

Amount

(select one below)

[e.g., 08/555,555]

(37 CFR 1.20(e)‐(g)

(37 CFR 1.20(h))

Column 5

3.5 yrs

7.5 yrs

11.5 yrs

Column 2

Column

Column 4

Subtotals: Columns 3 & 4

_______ additional sheets attached for

listing additional patents.

Total Payment

* Information required by 37 CFR 1.366(c) (columns 1 & 2). Information requested under 37 CFR 1.366(d) (columns 3, 4, & 5).

WARNING: Information on this form may become public. Credit card information should not be included on this

Respectfully submitted,**

Customer’s Signature _____________________________________

Customer’s Name ________________________________________ Registration Number, if applicable: __________________________

Telephone:

_____________________________________________ Fax: ___________________________________________________

Note: All correspondence will be forwarded to the “Fee Address” or to the “Correspondence Address” if no “Fee Address” has been provided.

Payment of small entity fee is appropriate if small entity status still exists, see 37 CFR 1.27(g). To establish small entity status or to notify of a

loss of entitlement to small entity status, a written assertion is required. See 37 CFR 1.27 and 1.33(b). Payment of micro entity fee is

appropriate if patent owner certifies micro entity status. Form PTO/SB/15A or B or equivalent must either be enclosed or have been

submitted previously. To notify of a loss of entitlement to micro entity status, a written assertion is required. See 37 CFR 1.29 and 1.33(b).

** WHERE MAINTENANCE FEE PAYMENTS ARE TO BE MADE BY AUTHORIZATION TO CHARGE A DEPOSIT ACCOUNT, BOTH THE

NAME AND SIGNATURE OF AN AUTHORIZED USER ARE REQUIRED.

This collection of information is required by 37 CFR 1.366. 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 collection is estimated to take 5 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 Information 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: Director of the United States Patent and Trademark Office, Attn: Maintenance Fee, 2051 Jamieson Avenue, Suite 300, Alexandria, VA 22314.

If you need assistance in completing the form, call 1‐800‐PTO‐9199 and select option 2.