PTO/AlA/96 (08-12)
`Approved for use through 01/31/2013. OMB 0651-0031
`US. Patent and Trademark Office; US. DEPARTMENT OF COMMERCE
`Underthe Paoerwork Reduction Act of 1995, no oersons are reouired to resoond to a collection of information unless it dis-la s a valid OMB control number.
`
`AW Docket“ 43870050004
`STATEMENT UNDER 37 CFR 3.73(c)
`
`Applicant/Patent Owner: BTL Medical Technologies S.R.O.
`
`Application No./Patent No.: 15/601,719
`Filed/Issue Date: May 22, 2017
`Titled: AESTHETIC METHOD OF BIOLOGICAL STRUCTURE TREATMENT BY MAGNETIC FIELD
`
`BTL Medical Technologies S.R.O.
`, 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. I: An assignee of less than the entire right, title, and interest (check applicable box):
`
`%. Additional Statement(s) by the owners
`D 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.
`
`I: There are unspecified percentages of ownership. 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.
`
`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 (9.9., 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):
`
`A. |:' 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
`, Frame
`, or for which a copy
`thereof is attached.
`
`B.
`
`A chain of title from the inventor(s), of the patent application/patent identified above, to the current assignee as follows:
`
`1. From; TOMAS SCHWARZ
`To; BTL Holdings Limited
`The document was recorded in the United States Patent and Trademark Office at
`
`, or for which a copy thereof is attached.
`, Frame 0432
`Reel 042575
`
`2_ From: BTL Holdings Limited
`To: Medical Technologies CZ a.s.
`The document was recorded in the United States Patent and Trademark Office at
`
`Reel 048166
`
`, Frame 0023
`
`, or for which a copy thereof is attached.
`
`[Page 1 of 2]
`This collection of information is required by 37 CFR 3.73(b). 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 12 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 FEES OR COMPLETED FORMS TO THIS ADDRESS. SEND
`TO: Commissioner for Patents, P.O. Box 1450, Alexandria, VA 22313-1450.
`
`Ifyou need assistance in completing the form, call I -800-PTO-91 99 and select Option 2.
`
`

`

`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 Paoerwork Reduction Act of 1995, no oersons are reouired to resoond to a collection of information unless it dis-la s a valid OMB control number.
`
`STATEMENT UNDER 37 CFR 3.73mi
`
`To: BTL Medical Technologies S.R.O.
`3, From: Medical Technologies CZ a.s.
`The document was recorded in the United States Patent and Trademark Office at
`
`Reel 050034
`
`, Frame 0451
`
`, or for which a copy thereof is attached.
`
`To:
`
`The document was recorded in the United States Patent and Trademark Office at
`
`Reel
`
`, Frame
`
`, or for which a copy thereof is attached.
`
`To:
`
`The document was recorded in the United States Patent and Trademark Office at
`
`Reel
`
`, Frame
`
`, or for which a copy thereof is attached.
`
`To:
`
`The document was recorded in the United States Patent and Trademark Office at
`
`Reel
`
`, Frame
`
`, or for which a copy thereof is attached.
`
`|:|
`
`Additional documents in the chain of title are listed on a supplemental sheet( ).
`
`
`
`IX]
`
`As required by 37 CFR 3.73(c)(1)(i), the documentary evidence of the chain of title from the original owner to the
`assignee was, or concurrently is being, submitted for recordation pursuant to 37 CFR 3.11.
`
`[NOTE: A separate copy (Le, a true copy of the original assignment document(s)) must be submitted to Assignment
`Division in accordance with 37 CFR Part 3, to record the assignment in the records of the USPTO. See MPEP 302.08]
`
`The undersigned (whose title is supplied below) is authorized to act on behalf of the assignee.
`
`
`/Richard D. Coller 111/
`September 27, 2019
`Signature
`Date
`
`Richard D. Coller III
`Printed or Typed Name
`
`Director
`
`[Page 2 of 2]
`
`60,390
`Title or Registration Number
`
`