PTO/AlA/96 (08-12)
`Approved for use through 01/31/2013. OMB 0651-0031
`US. Patent and Trademark Office; US. DEPARTMENT OF COMMERCE
`Under the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number.
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`STATEMENT UNDER 37 CFR 3.73(c)
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`Appncant/Patentowner: Predictive Therapeutics, LLC
`
`Application No./Patent No.: 9,149,499
`Filed/Issue Date: OCtOber 6: 2015
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`Titled: Cannabis Based Therapeutic and Method of Use
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`Predictive Therapeutics, LLC
`. a corporation
`(Name of Assignee)
`(Type of Assignee, e.g., corporation, partnership, university, government agency, etc.)
`
`states that, for the patent application/patent identified above, it is (choose one of options 1, 2, 3 or 4 below):
`
`1.
`
`The assignee of the entire right, title, and interest.
`
`2. D An assignee of less than the entire right, title, and interest (check applicable box):
`
`%. Additional Statement(s) by the owners
`I_| The extent (by percentage) of its ownership interest is
`holding the balance of the interest must be submitted to account for 100% of the ownership interest.
`
`C] There are unspecified percentages of ownership. The other parties, including inventors, who together own the entire
`right, title and interest are:
`
`
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`Additional Statement(s) by the owner(s) holding the balance of the interest must be submitted to account for the entire
`right, title, and interest.
`
`3. I: The assignee of an undivided interest in the entirety (a complete assignment from one of the joint inventors was made).
`The other parties, including inventors, who together own the entire right, title, and interest are:
`
`Additional Statement(s) by the owner(s) holding the balance of the interest must be submitted to account for the entire
`right, title, and interest.
`
`4. I: The recipient, via a court proceeding or the like (e.g., bankruptcy, probate), of an undivided interest in the entirety (a
`complete transfer of ownership interest was made). The certified document(s) showing the transfer is attached.
`
`The interest identified in option 1, 2 or 3 above (not option 4) is evidenced by either (choose % of options A or B below):
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`A. IE An assignment from the inventor(s) of the patent application/patent identified above. The assignment was recorded in
`the United States Patent and Trademark Office at Reel 036709
`, Frame 0009
`, or for which a copy
`thereof is attached.
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`B. E] A chain of title from the inventor(s), of the patent application/patent identified above, to the current assignee as follows:
`To:
`
`1. From:
`
`The document was recorded in the United States Patent and Trademark Office at
`
`, or for which a copy thereof is attached.
`, Frame
`Reel
`To:
`
`2. From:
`
`The document was recorded in the United States Patent and Trademark Office at
`
`Reel
`
`, Frame
`
`, or for which a copy thereof is attached.
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`[Page 1 of 2]
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`
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`
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