Application Data Sheet 37 CFR 1,76 —W
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`PTO AlA/14 Equivalent (11-15)
`0%
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`Title of Invention HIGH POWER TIME VARYING MAGNETIC FIELD THERAPY
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`Application Number
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`15/404,384
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`printed and included in a paper filed application
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`The application data sheet is part of the provisional or nonprovisional application for which it is being submitted. The following form contains the bibliographic
`data arranged in a format specified by the United States Patent and Trademark Office as outlined in 37 CFR 176.
`This document may be completed electronically and submitted to the Office in electronic format using the Electronic Filing System (EFS) or the document may be
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`Corres I 0ndence In 0rmati0n:
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`
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`Customer Number
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`34055 26111
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`A I Ilication In 0rmati0n:
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`Title of Invention
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`HIGH POWER TIME VARYING MAGNETIC FIELD THERAPY
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`34055_26m
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`4—3870020008
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`Attorney Docket Number
`Application Type (og Nonprovisional Provisional)
`Sub'ect Matter (e.
`.
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`n,lant desin)
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`Small Entity Status Claimed
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`Total Number ofDrawing Sheets (ifany) _ Suggested Figure for Publication (ifany)_—
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`Re I resentative In 0rmati0n:
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`Representative information should be provided for all practitioners having a power of attorney in the application. Providing this information in
`the Application Data Sheet does not constitute a power of attorney in the application (see 37 CFR 1.32). Either enter Customer Number or
`complete the Representative Name section below. If both sections are completed the Customer Number will be used for the Representative
`Information durin_ urocessin_.
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`A licant In 0rmati0n:
`Providing assignment information in this section does not substitute for compliance with any requirement of part 3 of Title 37 of the CFR to
`have an assignment recorded by the Office.
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`
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`Applicant 1
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`Ifthe applicant is the inventor (or the remaining joint inventor or inventors under 37 CFR 1.45), this section should not be completed. The
`information to be provided in this section is the name and address of the legal representative who is the applicant under 37 CFR 1.43; or the
`name and address of the assignee, person to whom the inventor is under an obligation to assign the invention, or person who otherwise shows
`sufficient proprietary interest in the matter who is the applicant under 37 CFR 1.46. Ifthe applicant is an applicant under 37 CFR 1.46
`(assignee, person to whom the inventor is obligated to assign, or person who otherwise shows sufficient proprietary interest) together with one
`or more joint inventors, then the joint inventor or inventors who are also the applicant should be identified in this section.
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`If Applicantis the legal representative, indicate the authority to file the patent application, the inventor is:
`El Deceased
`I:I Legally Incapacitated
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`Name of the Deceased or Legally Incapacitated Inventor:
`If the Applicant is an Organization check here: 2
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`Organization Name: m' ' Medical Technologies CZ as.
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`Mailing Address Information for Applicant:
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`Address 1
`Address 2
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`Kennedy—64 Evropska 423/178
`Offiee—G
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`-1-
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`Application Data Sheet 37 CFR 1.76 —W
`
`W
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`Application Number
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`15/4043 84
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`
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`Title of Invention HIGH POWER TIME VARYING MAGNETIC FIELD THERAPY
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`Cit
`
`Si . nature:
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`Nieesia_g_Praue 6 ——
`[[CYiic_Z
`Postal Code
`[[1076]]160 00
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`NOTE: This Application Data Sheet must be signed in accordance with 37 CFR l.33(b). However, if this Application Data Sheet is
`submitted with the INITIAL filing of the application an_d either box A or B is n_0t checked in subsection 2 of the “Authorization or Opt-
`Out of Authorization to Permit Access” section, then this form must also be signed in accordance with 37 CFR 1.14(c).
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`This Application Data Sheet M be signed by a patent practitioner if one or more of the applicants is a juristic entity (6. g., corporation or
`association). If the applicant is two or more joint inventors, this form must be signed by a patent practitioner, a_ll joint inventors who are the
`applicant, or one or more joint inventor-applicants who have been given power of attorney (e.g., see USPTO Form PTO/AIA/8 l) on behalf of
`a_ll joint inventor-applicants.
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`See 37 CFR 1.4(d) for the manner of making signatures and certifications.
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`
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`Signature
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`/Richard D. Coller 111/
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`Date (YYYY-MM-DD) April 19, 2019
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`Richard D.
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`Coller III
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`Registration Number
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`60,3 90
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`13044859
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