`
`EFS ID:
`
`Application Number:
`
`19377137
`
`10722102
`
`International Application Number:
`
`Confirmation Number:
`
`6375
`
`Title of Invention:
`
`KNEE ARTHROPLASTY METHOD
`
`First Named Inventor/Applicant Name:
`
`Peter M. Bonutti
`
`Customer Number:
`
`22882
`
`Filer:
`
`Brent David Martin
`
`Filer Authorized By:
`
`Attorney Docket Number:
`
`180.0044-03000
`
`Receipt Date:
`
`Filing Date:
`
`Time Stamp:
`
`23-JUN-2014
`
`25-NOV-2003
`
`12:17:16
`
`Application Type:
`
`Utility under 35 USC 111(a)
`
`Payment information:
`
`Submitted with Payment
`Payment Type
`Payment was successfully received in RAM
`RAM confirmation Number
`
`yes
`
`Deposit Account
`
`$
`
`160
`
`9638
`
`Charge any Additional Fees required under 37 C.F.R. Section 1.21 (Miscellaneous fees and charges)
`
`Deposit Account
`Authorized User
`The Director of the USPTO is hereby authorized to charge indicated fees and credit any overpayment as follows:
`
`Charge any Additional Fees required under 37 C.F.R. Section 1.20 (Post Issuance fees)
`
`501068
`
`Exhibit BSI-2004
`Wright Medical Inc. v.
`Bonutti Skeletal
`Innovations LLC
`Trial: IPR2014-00354
`
`
`
`File Listing:
`Document
`Number
`
`Document Description
`
`File Name
`
`File Size(Bytes)/
`Message Digest
`
`Multi
`Part /.zip
`
`Pages
`(if appl.)
`
`1
`
`Statutory disclaimers per MPEP 1490.
`
`Disclaimer_1321a.pdf
`
`Warnings:
`Information:
`
`2
`
`Fee Worksheet (SB06)
`
`fee-info.pdf
`
`168019
`
`0e796d1519415104456e1477c213f39b087
`443d3
`
`29875
`
`3e328bf184ff598b6f1fb795f92878f27c129
`89e
`
`no
`
`no
`
`2
`
`2
`
`Warnings:
`Information:
`
`Total Files Size (in bytes):
`
`197894
`
`This Acknowledgement Receipt evidences receipt on the noted date by the USPTO of the indicated documents,
`characterized by the applicant, and including page counts, where applicable. It serves as evidence of receipt similar to a
`Post Card, as described in MPEP 503.
`
`
`New Applications Under 35 U.S.C. 111
`If a new application is being filed and the application includes the necessary components for a filing date (see 37 CFR
`1.53(b)-(d) and MPEP 506), a Filing Receipt (37 CFR 1.54) will be issued in due course and the date shown on this
`Acknowledgement Receipt will establish the filing date of the application.
`
`National Stage of an International Application under 35 U.S.C. 371
`If a timely submission to enter the national stage of an international application is compliant with the conditions of 35
`U.S.C. 371 and other applicable requirements a Form PCT/DO/EO/903 indicating acceptance of the application as a
`national stage submission under 35 U.S.C. 371 will be issued in addition to the Filing Receipt, in due course.
`
`New International Application Filed with the USPTO as a Receiving Office
`If a new international application is being filed and the international application includes the necessary components for
`an international filing date (see PCT Article 11 and MPEP 1810), a Notification of the International Application Number
`and of the International Filing Date (Form PCT/RO/105) will be issued in due course, subject to prescriptions concerning
`national security, and the date shown on this Acknowledgement Receipt will establish the international filing date of
`the application.
`
`
`
`Doc Code:
`
`PTO/SB/43 (07-09)
`Approved for use through 07/31/2012. 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.
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`DISCLAIMER IN PATENT UNDER 37 CFR 1.321(a)
`
`Name of Patentee
`(cid:35)(cid:48)(cid:47)(cid:54)(cid:53)(cid:53)(cid:42)(cid:1)(cid:52)(cid:44)(cid:38)(cid:45)(cid:38)(cid:53)(cid:34)(cid:45)(cid:1)(cid:42)(cid:47)(cid:47)(cid:48)(cid:55)(cid:34)(cid:53)(cid:42)(cid:48)(cid:47)(cid:52)(cid:1)(cid:45)(cid:45)(cid:36)
`Patent Number
`(cid:24)(cid:13)(cid:25)(cid:17)(cid:23)(cid:13)(cid:25)(cid:26)(cid:23)
`Title of Invention
`
`(cid:44)(cid:47)(cid:38)(cid:38)(cid:1)(cid:34)(cid:51)(cid:53)(cid:41)(cid:51)(cid:48)(cid:49)(cid:45)(cid:34)(cid:52)(cid:53)(cid:58)(cid:1)(cid:46)(cid:38)(cid:53)(cid:41)(cid:48)(cid:37)
`
`Docket Number (Optional)
`(cid:18)(cid:25)(cid:17)(cid:15)(cid:17)(cid:17)(cid:21)(cid:21)(cid:14)(cid:17)(cid:20)(cid:17)(cid:17)(cid:17)
`Date Patent Issued
`(cid:48)(cid:68)(cid:85)(cid:80)(cid:67)(cid:70)(cid:83)(cid:1)(cid:22)(cid:13)(cid:1)(cid:19)(cid:17)(cid:18)(cid:17)
`
`I hereby disclaim the following complete claims in the above identified patent:
`
`(cid:21)(cid:17)
`
`The extent of my interest in said patent is (if assignee of record, state liber and page, or reel and frame, where
`(cid:18)(cid:17)(cid:17)(cid:6)(cid:1)(cid:9)(cid:51)(cid:70)(cid:70)(cid:77)(cid:16)(cid:39)(cid:83)(cid:66)(cid:78)(cid:70)(cid:27)(cid:1)(cid:17)(cid:18)(cid:20)(cid:26)(cid:17)(cid:20)(cid:16)(cid:17)(cid:17)(cid:24)(cid:17)(cid:28)(cid:1)(cid:17)(cid:18)(cid:22)(cid:22)(cid:22)(cid:19)(cid:16)(cid:17)(cid:20)(cid:21)(cid:19)(cid:28)(cid:18)(cid:24)(cid:23)(cid:17)(cid:20)(cid:16)(cid:17)(cid:19)(cid:17)(cid:24)(cid:28)
`assignment is recorded):
`(cid:17)(cid:19)(cid:25)(cid:26)(cid:20)(cid:17)(cid:16)(cid:17)(cid:18)(cid:21)(cid:18)(cid:28)(cid:1)(cid:17)(cid:19)(cid:25)(cid:26)(cid:21)(cid:25)(cid:16)(cid:17)(cid:25)(cid:17)(cid:20)(cid:28)(cid:1)(cid:66)(cid:79)(cid:69)(cid:1)(cid:17)(cid:19)(cid:25)(cid:26)(cid:22)(cid:26)(cid:16)(cid:17)(cid:18)(cid:17)(cid:26)(cid:10)(cid:1)
`The fee for this disclaimer is set forth in 37 CFR 1.20(d).
`
`Patentee claims small entity status. See 37 CFR 1.27.
`
`Small entity status has already been established in this case, and is still proper.
`
`A check in the amount of the fee is enclosed.
`
`Payment by credit card. Form PTO-2038 is attached.
`
`(cid:57)
`
`The Director is hereby authorized to charge any fees which may be required or credit any
`(cid:22)(cid:17)(cid:14)(cid:18)(cid:17)(cid:23)(cid:25)
`overpayment to Deposit Account No. ________________ .
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`Signed at
`
`(cid:49)(cid:77)(cid:66)(cid:79)(cid:80)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:53)(cid:70)(cid:89)(cid:66)(cid:84)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1) (cid:19)(cid:20)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)
`this
` , State of
` ,
`(cid:16)(cid:35)(cid:83)(cid:70)(cid:79)(cid:85)(cid:1)(cid:37)(cid:15)(cid:1)(cid:46)(cid:66)(cid:83)(cid:85)(cid:74)(cid:79)(cid:16)
`
`Signature
`
`(cid:35)(cid:83)(cid:70)(cid:79)(cid:85)(cid:1)(cid:37)(cid:15)(cid:1)(cid:46)(cid:66)(cid:83)(cid:85)(cid:74)(cid:79)
`Typed or printed name of patentee/ attorney or agent of record
`
`(cid:22)(cid:18)(cid:22)(cid:18)(cid:1)(cid:41)(cid:70)(cid:66)(cid:69)(cid:82)(cid:86)(cid:66)(cid:83)(cid:85)(cid:70)(cid:83)(cid:84)(cid:1)(cid:37)(cid:83)(cid:74)(cid:87)(cid:70)(cid:13)(cid:1)(cid:52)(cid:86)(cid:74)(cid:85)(cid:70)(cid:1)(cid:18)(cid:24)(cid:17)
`
`Address
`
`(cid:49)(cid:77)(cid:66)(cid:79)(cid:80)(cid:13)(cid:1)(cid:53)(cid:57)(cid:13)(cid:1)(cid:24)(cid:22)(cid:17)(cid:19)(cid:21)
`
`City, State, Zip Code or Foreign Country as applicable
`
`(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:43)(cid:86)(cid:79)(cid:70)
`day of
`
`(cid:1)(cid:1)(cid:1)(cid:1)(cid:18)(cid:21)
`20
`
` .
`
`(cid:23)(cid:19)(cid:13)(cid:24)(cid:18)(cid:24)
`Registration Number, if
`applicable
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