PTO/SB/47 (03-09)
`Approved for use through 05/31/2015. OMB 0651 -0018
`U.S. Patent and Trademark Office; U. 8. DEPARTMENT OF COMMERCE
`Under the Paperwork Reduction Act of 1995, no persons are required to respond to a coliection of information unless it dispiays a valid OMB control number.
`
`“FEE ADDRESS” iNDlCATION FORM
`
`Address to:
`
`Mail Stop M Correspondence
`Commissioner for Patents
`P.0. Box 1450
`
`Fax to:
`
`571 -273-6500
`
`Alexandria, VA 22313-1450
`
`in addition,
`INSTRUCTIONS: The issue fee must have been paid for application(s) iisted on this form.
`oniy an address represented by a Customer Number can be estabiished as the fee address for maintenance
`fee purposes (hereafter, tee address). A fee address should be established when correspondence related to
`maintenance fees should be mailed to a different address than the correspondence address for the application.
`When to check the first box below: it you have a Customer Number to represent the fee address. When
`to check the second box below: If you have no Customer Number representing the desired tee address,
`in which case a compieted Request for Customer Number (PTO/SB/125) must be attached to this form. For
`more information on Customer Numbers, see the Manuai of Patent Examining Procedure (MPEP) § 403.
`
`For the foiiowing listed appiication(s), piease recognize as the “Fee Address” under the provisions of 37 CFR
`1.363 the address associated with:
`
`Customer Number: 0 0758
`
`OR
`
`D The attached Request for Customer Number (PTO/SB/125) form.
`
`PATENT NUMBER
`(it known)
`
`APPLICATION NUMBER
`
`9,085,778
`
`11/799,148
`
`
`
`Completed by (check one):
`
`D Appiicant/lnventor
`
`/GeneH.Yee/—
`Signature
`
`Attorney or Agent of record 57:471
`(Reg. No.)
`
`Gene H. Yee
`
`Typed or printed name
`
`|:| Assignee of record of the entire interest. See 37 CFR 3.71.
`Statement under 37 CFR 3.73(b) is enciosed.
`(Form PTO/SB/96)
`
`206-389-4510
`Requester’s teiephone number
`
`|:| Assignee recorded at Reei
`
`Frame
`
`Aprit 18, 2016
`
`Date
`
`NOTE: Signatures of all the inventors or assignees of record of the entire interest or their representative(s) are required. Submit multipie forms if more that one
`signature is required, see below".
`* Total of
`
`forms are submitted.
`
`This collection of information is required by 37 CFR 1.363. 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. Confidentiaiity is governed by 35 U.S.C. 122 and 37 CFR 1. 11 and 1.14. This colie ction is estimated to take 5 minutes to comptete,
`including gathering, preparing. and submitting the compieted apptication form to the USPTO, Time witl 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, shoutd be sent to the Chief information Officer. US. Patent and
`Trademark Office, U.S. Department of Commerce, P.O. Box 1450, Alex andria, VA 22313— 1450. DO NOT SEND COMPLETE D FORMS TO THlS A DDRESS.
`SEND TO: Maii Stop M Correspondence, Commissioner for Patents, P.O. Box 1450, Alexandria, VA 22313-1450.
`Ifyou need assistance in completing the form, call 1-800-PTO-9199 and select option 2.
`
`

`

`Privacy Act Statement
`
`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 reiated to a patent application or patent. Accordingly,
`pursuant to the requirements of the Act, piease be advised that: (1) the generai authority for the
`collection of this information is 35 U.S.C. 2(b)(2); (2) furnishing of the information solicited is voiuntary;
`and (3) the principai purpose for which the information is used by the US. Patent and Trademark
`Office is to process and/or examine your submission related to a patent apptication or patent. if you do
`not furnish the requested information, the US. Patent and Trademark Office may not be able to
`process and/or examine your submission, which may resuit in termination of proceedings or
`abandonment of the apptication or expiration of the patent.
`
`The information provided by you in this form will be subject to the fotlowing routine uses:
`
`1. The information on this form will be treated confidentialty to the extent allowed under the
`Freedom of lnformation Act (5 U.S.C. 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
`disclosure of these records is required by the Freedom of information Act.
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`A record in this system of records may be disclosed, as a routine use, to a Member of
`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 record in 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
`information shatt be required to compiy with the requirements of the Privacy Act of 1974, as
`amended, pursuant to 5 U.S.C. 552a(m).
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`this system of records may be disclosed, as a routine use, to the international Bureau of the
`World intellectuai Property Organization, pursuant to the Patent Cooperation Treaty.
`A record in this system of records may be disclosed, as a routine use, to another federal
`agency for purposes of National Security review (35 U.S.C. 181) and for review pursuant to
`the Atomic Energy Act (42 U.S.C. 218(c)).
`A record from this system of records may be disctosed, 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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`
`A record from this system of records may be disciosed, as a routine use, to the pubiic after
`either publication of the apptication 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 was filed in an application which
`became abandoned or in which the proceedings were terminated and which application is
`referenced by either a pubiished appiication, an application open to public inspection or an
`issued patent.
`A record from this system of records may be disclosed, as a routine use, to a Federal, State,
`or locai iaw enforcement agency, if the USPTO becomes aware of a violation or potential
`viotation of law or regulation.
`
`