Paperwork Reduction Act of 1995, no pe
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`REISSUE APPLICATION: CONSENT OF ASSIGNEE;
`
`PTO/SBV/53 (09-07)
`Approved for use through 08/31/2013. OMB 0651-0033
`U.S, Patent and Trademark Office; U.S. DEPARTMENT OF COMMERCE
`quired to respond to a collection of Information unless it displays
`a valid OMB contro! number.
`Docket Number(Optional)
`
` This is part of the application for a reissue patent based
`Name of Patentee(s)
`Robert M. Allen
`Patent Number
`7,792,686
`Title of Invention
`
`STATEMENT OF NON-ASSIGNMENT
`
`1516.15
`
`.
`Date Patent Issue
`09/07/2010
`
`Medical Benefits Payment System
`
`1.
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`Filed herein is a statement under 37 CFR 3.73(b). (Form PTO/SB/96)
`
`2. [_] Ownershipof the patentis in the inventor(s), and no assignmentof the patentis in effect.
`
`One of boxes 1 or 2 above must be checked.If multiple assignees, complete this form for each assignee.If
`box 2 is checked, skip the next entry and go directly to “Name of Assignee’.
`
`The written consentof afl assignees and inventors owning an undivided interest in the original
`atent is includedin this application for reissue.
`
`The assignee(s) owning an undivided interestin said original patent is/are StoneEagle Services,Inc.
`and the assignee(s) consents to the accompanying application for reissue.
`
`Nameofassignee/inventor(if not assig e¢
`
`Phillip Bogner, President
`
`This collection of information is required by 37 CFR 1.172. The information is required to obtain orretain a benefit by the public which is to file (and by the USPTO
`to process) an application. Confidentiality is governed by 35 U.S.C. 122 and 37 CFR 1.14. This collection is estimated to take 6 minutes to complete,including
`gathering, preparing, and submitting the completed appilcation form to the USPTO. Time will vary depending upon the individual case. Any comments on the
`amountof time you require to complete this form and/or suggestions far restuning trés humica, ghauid fc 7
`a
`
`Trademark Office, U.S. Department of Commerce, P.O, Box 1450, Alexendria, VA 22314-1480 90 NOT SF
`ADDRESS. SEND TO: Commissioner for Patenis, P.O. Box in, Alexandria, ¥A ERE S-T-4iu
`
`ifyou need assistance in completing the form, call 1-800-PTO-9199 and selectoption 2.
`
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