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
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`rowonesuuc
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`Docket Number (Optional)
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`Date Patent Issued
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`Name of Patentee
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`Patent Number
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`Title of Invention
`SYSTEM AND METHOD FOR LOCATING A HEARING AID
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`| hereby disclaim the following complete claims in the aboveidentified patent:
`1-20
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`The extent of myinterestin said patentis (if assignee of record, state liber and page, or reel and frame, where
`assignment is recorded): Assignee of Record (Reel/Frame: 036536/0249)
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`Thefee for this disclaimeris set forth in 37 CFR 1.20(d).
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`Patentee claims small entity status. See 37 CFR 1.27.
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`Small entity status has already been establishedin this case, and isstill proper.
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`A check in the amountofthe fee is enclosed.
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`Paymentbycredit card. Form PTO-2038is attached.
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`The Director is hereby authorized to charge any fees which may be required or credit any
`overpayment to Deposit Account No. 50-1662
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`WARNING: Information on this form may becomepublic. Credit card information should not
`be included onthis form. Provide credit card information and authorization on PTO-2038.
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`Under the Paperwork Reduction Act of 1995, no persons are required to respondto a collection of information unlessit displays a valid OMB control number. DISCLAIMER IN PATENT UNDER 37 CFR 1.321(a)
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`Signed at was hinston
`, State of ). Gi
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`this(974 dayofslanvavy
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`bi
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`Signature
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`Henry A. Petri, Jr.
`Typed or printed nameof patentee/ attorney or agent of record
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`1000 Louisiana Street, Fifty-Third Floor
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`Address
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`Houston, TX 77002
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`City, State, Zip Code or Foreign Country as applicable
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`ool
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`33,063
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`Registration Number,if
`applicable
`713-374-1600
`Telephone Number
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`This collection of information is required by 37 CFR 1.321. The information is required to obtain or retain a benefit by the public whichis to file (and by the
`USPTOto 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 uponthe individual case.
`Any comments on the amountof 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: Commissionerfor Patents, P.O. Box 1450, Alexandria, VA 22313-1450.
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`if you need assistance in completing the form, call 1-800-PTO-9199 and selectoption 2.
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`Page 1 of 2
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`III HOLDINGS 4, LLC
`Exhibit 2001
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`Page 1 of 2
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`III HOLDINGS 4, LLC
`Exhibit 2001
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`Privacy Act Statement
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`The Privacy Act of 1974 (P.L. 93-579) requires that you be given certain information in connection
`with your submission of the attached form related to a patent application or patent. Accordingly,
`pursuantto the requirements of the Act, please be advisedthat: (1) the general authority for the
`collection of this information is 35 U.S.C. 2(b)(2); (2) furnishing of the information solicited is voluntary;
`and (3) the principal purpose for which the information is used by the U.S. Patent and Trademark
`Office is to process and/or examine your submission related to a patent application or patent. If you do
`not furnish the requested information, the U.S. Patent and Trademark Office may not be able to
`process and/or examine your submission, which may result in termination of proceedings or
`abandonmentof the application or expiration of the patent.
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`The information provided by you in this form will be subject to the following routine uses:
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`1. The information on this form will be treated confidentially to the extent allowed under the
`Freedom of Information Act (5 U.S.C. 552) and the Privacy Act (5 U.S.C 552a). Records from
`this system of records may be disclosed to the Departmentof Justice to determine whether
`disclosure of these records is required by the Freedom of Information Act.
`A record from this system of records may be disclosed, as a routine use, in the course of
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`opposing counselin the course of settlement negotiations.
`A record in this system of records may be disclosed, as a routine use, to a Memberof
`Congress submitting a request involving an individual, to whom the record pertains, when the
`individual has requested assistance from the Member with respect to the subject matter of the
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`A recordin this system of records may be disclosed, as a routine use, to a contractor of the
`Agency having need for the information in order to perform a contract. Recipients of
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`amended, pursuant to 5 U.S.C. 552a(m).
`A record related to an International Application filed under the Patent Cooperation Treaty in
`this system of records may be disclosed, as a routine use, to the International Bureau of the
`WorldIntellectual Property Organization, pursuant to the Patent Cooperation Treaty.
`A recordin this system of records may be disclosed, as a routine use, to another federal
`agencyfor purposes of National Security review (35 U.S.C. 181) and for review pursuantto
`the Atomic Energy Act (42 U.S.C. 218(c)).
`A record from this system of records may be disclosed, as a routine use, to the Administrator,
`General Services, or his/her designee, during an inspection of records conducted by GSA as
`part of that agency’s responsibility to recommend improvements in records management
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`purpose, and any otherrelevant (i.e., GSA or Commerce) directive. Such disclosure shall not
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`A record from this system of records may be disclosed, as a routine use, to the public after
`either publication of the application pursuant to 35 U.S.C. 122(b) or issuance of a patent
`pursuant to 35 U.S.C. 151. Further, a record may be disclosed, subject to the limitations of 37
`CFR 1.14, as a routine use, to the public if the record wasfiled in an application which
`became abandonedor in which the proceedings were terminated and which application is
`referenced by either a published application, an application open to public inspection or an
`issued patent.
`A record from this system of records maybedisclosed, as a routine use, to a Federal, State,
`or local law enforcement agency,if the USPTO becomes awareof a violation or potential
`violation of law or regulation.
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`Page 2 of 2
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`III HOLDINGS 4, LLC
`Exhibit 2001
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`Page 2 of 2
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`III HOLDINGS 4, LLC
`Exhibit 2001
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