PTO/SB/47 (03-09)
`Approved for use through 07/31/2018. OMB 0651-0016
`US. Patent and Trademark Office; U. S. DEPARTMENT OF COMMERCE
`Under the Paperwork Reduction Act of1995, no persons are required to respond to a collection ofinformation unless it displays a valid OMB control number.
`
`“FEE ADDRESS” INDICATION FORM
`
`Address to:
`
`Mail Stop M Correspondence
`Commissioner for Patents
`P.O. Box 1450
`
`Fax to:
`
`571-273-6500
`
`Alexandria, VA 22313-1450
`
`In addition,
`INSTRUCTIONS: The issue fee must have been paid for application(s) listed on this form.
`only an address represented by a Customer Number can be established as the fee address for maintenance
`fee purposes (hereafter, fee address). A fee address should be established when correspondence related to
`maintenance fees should be mailed to a different address than the correspondence address forthe application.
`When to check the first box below: If you have a Customer Numberto represent the fee address. When
`to check the second box below: If you have no Customer Number representing the desired fee address,
`in which case a completed Request for Customer Number (PTO/SB/125) must be attached to this form. For
`more information on Customer Numbers, see the Manual of Patent Examining Procedure (MPEP) § 403.
`
`For the following listed application(s), please recognize as the “Fee Address” under the provisions of 37 CFR
`1.363 the address associated with:
`
`
`
`IEI CustomerNumberi 153508
`
`OR
`
`I:I The attached Request for Customer Number (PTO/SB/125) form.
`
`PATENT NUMBER
`(if known)
`
`APPLICATION NUMBER
`
`8,405,726
`
`13/470,860
`
`Completed by (check one):
`I:IApplicant/lnventor
`
`IEIAttorney or Agent of record _ 42540
`(Reg. No.)
`
`EAssignee of record of the entire interest. See 37 CFR 3.71.
`Statement under 37 CFR 3.73(b) is enclosed.
`(Form PTO/SB/96)
`I:IAssignee recorded at Reel
`
`Frame_
`
`/Timothy A. Flory/
`Signature
`TImOthy A. Flory
`Typed or printed name
`
`_616'649'1924
`Requester’s telephone number
`
`May 4, 2018
`Date
`
`NOTE: Signatures ofall the inventors or assignees of record of the entire interest or their representative(s) are required. Submit multiple forms if more that one
`si nature is re uired see below*.
`
`forms are submitted.
`* Total of 1
`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. Confidentiality is governed by 35 U.S.C. 122 and 37 CFR 1. 11 and 1.14. This collection is estimated to take 5 minutes to complete,
`including gathering, preparing, and submitting the completed application form to the USPTO. Time will 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, should be sent to the Chief Information Officer, US. Patent and
`Trademark Office, US. Department of Commerce, PO. Box 1450, Alexandria, VA 22313- 1450. DO NOT SEND COMPLETE D FORMS TO THIS A DDRESS.
`SEND TO: Mail Stop M Correspondence, Commissioner for Patents, P.0. Box 1450, Alexandria, VA 22313-1450.
`Ifyou need assistance in completing the form, call 1-800-PTO-9199 and select option 2.
`
`