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`That no item of information contained in the information oisoiosure statement was cited in a communication from a
`foreign patent office in a counterpart foreign aopiioation, and, to the knowieoge of the person signing the certification
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`any inoiviouai designated in :3? CFR 1.56m more than three months prior to the fiiing of the information ttisciosirre
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`EE The fee set forth in 3? CFR ti? to) has been submitted herewith
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`SEGNATURE
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`A signature of the anpiioant or representative is required in accordance with CFR 1,33, tots. Piease see CPR taro) for the
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`This ooiieotion of information is required by 3? CFR 1.97 and 1.98. The information is required to obtain or retain a benefit by the
`puhiio which is to fiie (and hy the USPTQ to process) an aooiioation. Confidentiaiity is governed by 35 USC. 122 and 37 CPR
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`iaooiioation form to the U$FTQ Time wiii vary depending upon the individuei case. Any comments on the amount of time you
`require to oompiete this form andior suggestions for reducing this burden, shouid he sent to the Chief information Officerr US.
`‘ hatent and Trademark (Bffioe, LES. Department of Commerce. PO. Box 145:), Aiexandria, VA 2231344583. DC) NQT SEND
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`VA 22313445t}.
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`EFS Web 2 1(17
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`

`

`itriyacy Act etatement
`
`The Privacy Act of 1974 (PL. 93—57%) requires that you be given certain information in connection with your submission of in
`attached form rotated to a patent appiication or patent. Accordingiy, pursuant to the requirements of the Act, oiease he a‘du'isf
`that:
`(”ii the generai authority for the coiieotion of this information is 35 USS. more); (2) furnishing of the information soiictti
`is voiuntary: and (3) the principai purpose for which the information is used by the US. Patent and Trademark Ottice is to
`:
`process and/or examine your submission rotated to a patent appiication or patent.
`it you do not furnish the requested
`information, the us. Patent and Trademark Citiice may not be state to process andfor examine your submission, which may
`resuit in termination of proceedings or abandonment of the appiication or expiration of the patent.
`
`git
`
`The information provided by you in this form wiii be subject to the toiiowing routine uses:
`
`The information on this form wiii he treated confidentiaiiy to the extent aiiowed under the Freedom of information Act:
`USC. 552) and the Privacy Act (5 U.S.C. 552a). Records from this system of records may be disciosed to the
`‘
`Department of Justice to determine whether the Freedom of information Act requires disciosure of these records.
`
`A record from this system of records may he disciosed. as a routine use, in the course of presenting evidence to ac
`magistrate, or administrative trihunai, inciuding disciosures to opposing counsei in the course of settiement negotiate
`
`
`
`
`A record in this system of records may he disciosed, as a routine use, to a Member of Congress submitting a reduce~
`invoiving an individuai, to whom the record pertains, when the individuai has requested assistance from the iv’iemheri
`respect to the subject matter of the record.
`A record in this system of records may he disciosed, as a routine use. to a contractor of the Agency having need tori1
`information in order to perform a contract. Recipients of information shaii he required to compiy with the requirement
`the Privacy Actot1974, as amended, pursuant to 5 USC. 552atm).
`i
`
`A record reiated to an internationai Appiioation tiied under the Patent Cooperation Treaty in this system of records m{
`be disciosed, as a routine use, to the tnternationai Eiureau of the Worid inteiiectuai Property Organization, pursuant t
`the Patent Cooperation Treaty.
`
`A record in this system of records may he disciosed, as a routine use, to another tederai agency for purposes of Matt
`Security review (35 USC. 181) and for review pursuant to the Atomic Energy Act (42 USS, 218m».
`
`'
`
`A record from this system of records may be disciosed, as a routine use, to the Administrator, Generai Services, or ti
`her desighee, during an inspection of records conducted by GSA as part of that agency's responsihiiity to recommehi
`improvements in records management practices and programs, under authority or" 44 i136. 2994 and 2966. Such
`disciosure shalt be made in accordance with the GSA reputations governing inspection of records for this purpose, at
`any other reievant (i.e., GSA or Commerce) directive. Such disciosure shaii not he used to make determinations at) i
`individuais.
`
`A record from this system at records may be disciosed as a routine use, to the puhiic after either puoiication of the
`appiication pursuant to :35 USS. 122th) or issuance of a patent pursuant to 35 U.S.C. 151. Further, a record may hi
`disciosed, subject to the iimitations of 37’ CFR 1.14, as a routine use, to the puhiic it the record was tiied in an appiicri
`which became abandoned or in which the proceedings were terminated and which appiication is referenced hysittie‘
`puhiished appiioation, an appiioation open to pubiic inspections or an issued patent.
`
`A record from this system of records may he disciosed, as a routine use, to a Federai, State, or iocai iaw enforcemei
`agency, if the USPTO becomes aware of a vioiation or ootentiai vioiation of tow or reputation.
`
`1.
`
`
`
`EFS Web 235.17
`
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