Form Pto/sb/06 - Patent Application Fee Determination Record

Download a blank fillable Form Pto/sb/06 - Patent Application Fee Determination Record in PDF format just by clicking the "DOWNLOAD PDF" button.

Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.

Complete Form Pto/sb/06 - Patent Application Fee Determination Record with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.

Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.

Doc Code: WFEE

Document Description: Fee Worksheet (PTO-875)

PTO/SB/06 (09-16)

Approved for use through 11/30/2020. OMB 0651-0031

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.

Application or Docket Number

PATENT APPLICATION FEE DETERMINATION RECORD

Substitute for Form PTO-875

APPLICATION AS FILED – PART I

LARGE ENTITY

MICRO ENTITY

SMALL ENTITY

(Column 1)

(Column 2)

FOR

NUMBER FILED

NUMBER EXTRA

RATE ($)

FEE ($)

BASIC FEE

N/A

(37 CFR 1.16(a), (b), or (c))

SEARCH FEE

N/A

(37 CFR 1.16(k), (i), or (m))

EXAMINATION FEE

N/A

(37 CFR 1.16(o), (p), or (q))

TOTAL CLAIMS

minus 20 =

(37 CFR 1.16(i))

INDEPENDENT CLAIMS

minus 3 =

(37 CFR 1.16(h))

APPLICATION SIZE FEE

If the specification and drawings exceed 100 sheets

(37 CFR 1.16(s))

of paper, the application size fee due is $400 ($200

for small entity or $100 for micro entity) for each

additional 50 sheets or fraction thereof. See 35 U.S.C.

41(a)(1)(G) and 37 CFR 1.16(s).

MULTIPLE DEPENDENT CLAIM PRESENT (37 CFR 1.16(j))

N/A

* If the difference in column 1 is less than zero, enter “0” in column 2.

TOTAL

LARGE ENTITY

APPLICATION AS AMENDED – PART II

MICRO ENTITY

SMALL ENTITY

(Column 1)

(Column 2)

(Column 3)

CLAIMS

HIGHEST

REMAINING

NUMBER

PRESENT

ADDITIONAL

RATE ($)

AFTER

PREVIOUSLY

EXTRA

FEE ($)

AMENDMENT

PAID FOR

TOTAL

Minus

(37 CFR 1.16(i))

INDEPENDENT

Minus

***

(37 CFR 1.16(h))

APPLICATION SIZE FEE (37 CFR 1.16(s))

FIRST PRESENTATION OF MULTIPLE DEPENDENT CLAIM (37 CFR 1.16(j))

N/A

TOT!L !DD’L FEE

(Column 1)

(Column 2)

(Column 3)

CLAIMS

HIGHEST

REMAINING

NUMBER

PRESENT

ADDITIONAL

RATE ($)

AFTER

PREVIOUSLY

EXTRA

FEE ($)

AMENDMENT

PAID FOR

TOTAL

Minus

(37 CFR 1.16(i))

INDEPENDENT

Minus

***

(37 CFR 1.16(h))

APPLICATION SIZE FEE (37 CFR 1.16(s))

FIRST PRESENTATION OF MULTIPLE DEPENDENT CLAIM (37 CFR 1.16(j))

N/A

TOT!L !DD’L FEE

If the entry in column 1 is less than the entry in column 2, write “0” in column 3.

If the “Highest Number Previously Paid For” IN THIS SP!CE is less than 20, enter “20”.

*** If the “Highest Number Previously Paid For” IN THIS SP!CE is less than 3, enter “3”.

The “Highest Number Previously Paid For” (Total or Independent) is the highest number found in the appropriate box in column 1.

The information is required by 37 CFR 1.16. Confidentiality is governed by 35 U.S.C. 122 and 37 CFR 1.11 and 1.14. This collection is estimated to take 12 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

Commissioner for Patents, P.O. Box 1450, Alexandria, VA 22313-1450

ADDRESS. SEND TO:

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