Attorney Docket Number
`.
`.
`15/601,719
`Application Number
`AESTHETIC METHOD OF BIOLOGICAL STRUCTURE TREATMENT BY MAGNETIC
`FIELD
`
`43870050004
`
`PTO AIA/14 Equivalent (11-15)
`
`Application Data Sheet 37 CFR 1.76
`
`.
`
`.
`
`Title of Invention
`
`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 1.76.
`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
`printed and included in a paper filed application.
`
`Inventor In 0rmati0n:
`
`Inventor 1 Legal Name:
`
`Prefix II
`
`Given Name
`omas
`
`Middle Name
`
`Famil Name
`SCHWARZ
`
`Residence Information (Select One):
`Service
`[I Active US Milita
`[I US Residenc
`IXI Non US Residenc
`Cit
`State/Province — Countr of Residence
`
`
`
`Ci
`
`i
`
`
`Mailin_ Address of Inventor 2:
`Address 1
`8. Listoadu 2444/4a
`Address 2
`Cit
`Postal Code
`
`raue
`16900
`
`State/Provin ce
`Countr
`
`-_-——llN
`
`Inventor 2 Legal Name:
`
`Prefix
`
`Given Name
`Ondra
`
`Middle Name
`
`Famil Name
`"U
`ROUZA
`
`Residence Information (Select One):
`Service
`[I Active US Milita
`[I US Residenc
`IXI Non US Residenc
`Cit
`State/Province — Countr of Residence
`
`Z
`
`Mailin_ Address of Inventor 2:
`Address 1
`Edvarda Benese 146/28 Radosovice
`Address 2
`
`-—!'-———
`Postal Code
`_25101
`
`Si . nature:
`
`NOTE: This Application Data Sheet must be signed in accordance with 37 CFR 1.33(b). However, if this Application Data Sheet is
`submitted with the INITIAL filing of the application M 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).
`
`This Application Data Sheet M be signed by a patent practitioner if one or more of the applicants is a juristic entity (e.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 (6. g., see USPTO Form PTO/AIA/8 1) on behalf of
`a_ll joint inventor-applicants.
`
`See 37 CFR 1.4(d) for the manner of making signatures and certifications.
`
`Signature
`
`/Richard D. Coller 111/
`
`Date (YYYY-MM-DD)
`
`2019-10-23
`
`Richard D.
`
`CollerIII
`
`Registration Number
`
`1403909571.d0cx
`
`