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`
`-
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`4
`
`Extract from ETSI Rules of Procedure, 19 March 2014
`
`Page 1 (version 8)
`
`IPR INFORMATION STATEMENT AND LICENSING DECLARATION
`
`
`IPR HOLDER I ORGANISATION (“Declarant”)
`
`Optis Vlfireless Technology, LLC
`Legal Name:
`
`CONTACT DETAILS FOR LICENSING INFORMATION:
`
`Name and Title:
`Department:
`Address:
`
`Eric Tautfest, Chief Licensing Officer
`
`
`PO. Box 250649
`
`Telephone:
`
`Plano, TX 75025 US
`
`214—744-5000
`
`standardstanoptisipcom
`Email:
`
`IPR INFORMATION STATEMENT
`
`Fax:
`
`URL:
`
`In accordance with Clause 4.1 of the ETSI IPR Policy the Declarant and/or its AFFILIATES hereby informs
`ETSI that it is the Declarant’s and/or its AFFILIATES’ present belief that the IPR(s) disclosed in the attached
`IPR Information StatementAnnex may be or may become ESSENTIAL in relation to at least the ETSI Work
`ltem(s), STANDARD(S) and/or TECHNICAL SPECIFICATION(S) identified in the attached IPR Information
`Statement Annex.
`
`The Declarant and/or its AFFILIATES (check one box only):
`
`K4
`
`[:I
`
`are the proprietor of the lPR(s) disclosed in the attached IPR Information Statement Annex.
`
`are not the proprietor of the lPR(s) disclosed in the attached IPR Information Statement Annex.
`
`IPR LICENSING DECLARATION
`
`IPR Policy the Declarant and/or its AFFILIATES hereby
`In accordance with Clause 6.1 of the ETSI
`irrevocably declares the following (check one box only, and subordinate box, where applicable):
`
`g To the extent that the lPR(s) disclosed in the attached IPR Information Statement Annex are or
`become, and remain ESSENTIAL in respect of the ETSI Work Item, STANDARD and/or TECHNICAL
`SPECIFICATION identified in the attached IPR Information Statement Annex, the Declarant and/or its
`AFFILIATES are (1) prepared to grant irrevocable licences under this/these lPR(s) on terms and
`conditions which are in accordance with Clause 6.1 of the ETSI IPR Policy; and (2) will comply with
`Clause 6.1bis of the ETSI IPR Policy.
`
`[3 This irrevocable undertaking is made subject to the condition that those who seek licences
`agree to reciprocate (check box if applicable).
`
`I:] The Declarant and/or its AFFILIATES are not prepared to make the above IPR Licensing Declaration
`(reasons may be explained in writing in the attached IPR Licensing Declaration Annex).
`
`The construction, validity and performance of this IPR information statement and licensing declaration shall
`be governed by the laws of France.
`Terms in ALL CAPS on this form have the meaning provided in Clause 15 of the ETSI IPR Policy.
`
`SIGNATURE
`
`
`, 4,;
`
`By signing this IPR Information Statement and Licensing Declaration form, you represent that you have the
`authority to bind the Declarant and/or its AFFILIATES to the representations and commitments provided in
`this form.
`
`Name of authorized person:
`
`Eric Tautfest
`
`Title of authorized person:
`Place, Date:
`
`Signature:
`
`Chief Licensing Officer
`Texas, US /21 July 2014
`
`
`
`
`
`
`
`Please retum this form duly signed to: ETSI Director-General
`ETS/ — 650, route des Lucio/es - F—06921 Sophia Antipolis Cedex — France / Fax. +33 (0) 4 93 65 47 16
`
`
`1/14
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`|PR2020-00466
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