ࡱ > y ( bjbj A { { v v 8 t $ u! '$ @ 4 V V V : V V V r T H[Nb ^ 0 g$ V g$ g$ V V g$ v : PTO/AIA/ 96 (08-12)Approved for use through 01/31/2013. OMB 0651-0031U.S. Patent and Trademark Office; U.S. DEPARTMENT OF COMMERCEUnder 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. STATEMENT UNDER 37 CFR 3.73(c)Applicant/Patent Owner: FORMTEXT A p p l i c a t i o n N o . / P a t e n t N o . : F O R M T E X T F i l e d / I s s u e D a t e : F O R M T E X T T i t l e d : F O R M T E X T F O R M T E X T , a F O R M T E X T ( N a m e o f A s s i g n e e ) ( T y p e o f A s s i g n e e , e . g . , c o r p o r a t i o n , p a r t n e r s h i p , u n i v e r s i t y , g o v e rnment agency, etc.)states that, for the patent application/patent identified above, it is (choose one of options 1, 2, 3 or 4 below):1 FORMCHECKBOX The assignee of the entire right, title, and interest.2. FORMCHECKBOX An assignee of less than the entire right, title, and interest (check applicable box): FORMCHECKBOX The extent (by percentage) of its ownership interest is FORMTEXT % . A d d i t i o n a l S t a t e m e n t ( s ) b y t h e o w n e r s h o l d i n g t h e b a l a n c e o f t h e i n t e r e s t m u s t b e s u b m i t t e d t o a c c o u n t f o r 1 0 0 % o f t h e o w n e r s h i p i n t e r e s t . F O R M C H E C K B O X T h e r e a r e u n s p e c i f i e d p e r c e n t a g e s o f o w n e r s h i p . T h e o t h e r p a r t i e s , i n c l u d i n g i n v e n t o r s , w h o t o g e t h e r o w n t h e e n t i r e r i g h t , t i t l e a n d i n t e r e s t a r e : F O R M T E X T A d d i t i o n a l S t a t e m e n t ( s ) b y t h e o w n e r ( s ) h o l d i n g t h e b a l a n c e o f t h e i n t e r e s t m u s t b e s u b m i t t e d t o a c c o u n t f o r t h e e n t i r e r i g h t , t i t l e , a n d i n t e r e s t . 3 . F O R M C H E C K B O X T h e a s s i g n e e o f a n u n d i v i d e d i n t e r e s t i n t h e e n t i r e t y ( a c o m p l e t e a s s i g n m e n t f r o m o n e o f t h e j o i n t i n v e n t o r s w a s m a d e ) . T h e o t h e r p a r t i e s , i n c l u d i n g i n v e n t o r s , w h o t o g e t h e r o w n t h e e n t i r e r i g h t , t i t l e , a n d i n t e r e s t a r e : F O R M T E X T A d d i t i o n al Statement(s) by the owner(s) holding the balance of the interest must be submitted to account for the entire right, title, and interest.4. FORMCHECKBOX The recipient, via a court proceeding or the like (e.g., bankruptcy, probate), of an undivided interest in the entirety (a complete transfer of ownership interest was made). The certified document(s) showing the transfer is attached.The interest identified in option 1, 2 or 3 above (not option 4) is evidenced by either (choose one of options A or B b e l o w ) : A . F O R M C H E C K B O X A n a s s i g n m e n t f r o m t h e i n v e n t o r ( s ) o f t h e p a t e n t a p p l i c a t i o n / p a t e n t i d e n t i f i e d a b o v e . T h e a s s i g n m e n t w a s r e c o r d e d i n t h e U n i t e d S t a t e s P a t e n t a n d T r a d e m a r k O f f i c e a t R e e l F O R M T E X T , F r a m e F O R M T E X T , o r f o r w h i c h a c o p y t h e r e o f i s a t t a c h e d . B . F O R M C H E C K B O X A c h a i n o f t i t l e f r o m t h e i n v e n t o r ( s ) , o f t h e p a t e n t a p p l i c a t i o n / p a t e n t i d e n t i f i e d a b o v e , t o t h e c u r r e n t a s s i g n e e a s f o l l o w s : 1 . F r o m : F O R M T E X T T o : F O R M T E X T T h e d o c u m e n t w a s r e c o r d e d i n t h e U n i t e d S t a t e s P a t e n t a n d T r a d e m a r k O f f i c e a t R e e l F O R M T E X T , F r a m e F O R M T E X T , o r f o r w h i c h a c o p y t h e r e o f i s a t t a c h e d . 2 . F r o m : F O R M T E X T T o : F O R M T E X T T h e d o c u m e n t w a s r e c o r d e d i n t h e U n i t e d S t a t e s P a t e n t a n d T r a d e m a r k O f f i c e a t R e e l F O R M T E X T , F r a m e F O R M T E X T , o r f o r w h i c h a c o p y t h e r e o f i s a t t a c h e d . [ P a g e 1 o f 2 ] T h i s c o l l e c t i o n o f i n f o r mation is required by 37 CFR 3.73(b). 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 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 ADDRESS. SEND TO: Commissioner for Patents, P.O. Box 1450, Alexandria, VA 22313-1450. If you need assistance in completing the form, call 1-800-PTO-9199 and select option 2. PTO/AIA/ 96 (08-12)Approved for use through 01/31/2013. 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