PTO/SB/47 (03-09)
`Approved for use through 05/31/2015. OMB 0651-0016
`US. Patent and Trademark Office; U. S. 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.
`
`“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.
`
`Forthe following listed application(s), please recognize as the “Fee Address” underthe provisions of 37 CFR
`1.363 the address associated with:
`
`
`
`CustomerNumbe" 106960
`
`OR
`
`D The attached Request for Customer Number (PTO/SB/125) form.
`
`PATENT NUMBER
`(if known)
`
`APPLICATION NUMBER
`
`9934408
`
`15607820
`
`Completed by (check one):
`
`D Applicant/Inventor
`
`/BruceMargulies/
`
`Signature
`
`Attorney or Agent of record 54175
`(Reg. No.)
`
`Bruce Margulies
`Typed or printed name
`
`|:| Assignee of record of the entire interest. See 37 CFR 3.71.
`Statement under 37 CFR 3.73(b) is enclosed.
`(Form PTO/SB/96)
`
`703-415-0012
`Requester’s telephone number
`
`I:I Assignee recorded at Reel
`
`Frame
`
`5/18/2018
`
`Date
`
`NOTE: Signatures ofall the inventors or assignees of record of the entire interest ortheir representative(s) are required. Submit multiple forms if more that one
`signature is required, see below*.
`
`forms are submitted.
`* Total of
`|:|
`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 ofCommerce, 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.
`If you need assistance in completing the form, call 1-800-PTO-9199 and select option 2.
`
`

`

`Privacy Act Statement
`
`The Privacy Act of 1974 (P.L. 93-579) requires that you be given certain information in connection
`with your submission of the attached form related to a patent application or patent. Accordingly,
`pursuant to the requirements of the Act, please be advised that: (1) the general authority forthe
`collection of this information is 35 U.S.C. 2(b)(2); (2) furnishing of the information solicited is voluntary;
`and (3) the principal purpose for which the information is used by the US. Patent and Trademark
`Office is to process and/or examine your submission related to a patent application or patent. If you do
`not furnish the requested information, the US. Patent and Trademark Office may not be able to
`process and/or examine your submission, which may result in termination of proceedings or
`abandonment ofthe application or expiration of the patent.
`
`The information provided by you in this form will be subject to the following routine uses:
`
`1 . The information on this form will be treated confidentially to the extent allowed underthe
`Freedom of Information Act (5 U.S.C. 552) and the Privacy Act (5 U.S.C 552a). Records from
`this system of records may be disclosed to the Department of Justice to determine whether
`disclosure ofthese records is required by the Freedom of Information Act.
`A record from this system of records may be disclosed, as a routine use, in the course of
`presenting evidence to a court, magistrate, or administrative tribunal, including disclosures to
`opposing counsel in the course of settlement negotiations.
`A record in this system of records may be disclosed, as a routine use, to a Member of
`Congress submitting a request involving an individual, to whom the record pertains, when the
`individual has requested assistance from the Member with respect to the subject matter of the
`record.
`
`A record in this system of records may be disclosed, as a routine use, to a contractor of the
`Agency having need forthe information in orderto perform a contract. Recipients of
`information shall be required to comply with the requirements ofthe Privacy Act of 1974, as
`amended, pursuant to 5 U.S.C. 552a(m).
`A record related to an International Application filed under the Patent Cooperation Treaty in
`this system of records may be disclosed, as a routine use, to the International Bureau ofthe
`World Intellectual Property Organization, pursuant to the Patent Cooperation Treaty.
`A record in this system of records may be disclosed, as a routine use, to another federal
`agency for purposes of National Security review (35 U.S.C. 181) and for review pursuant to
`the Atomic Energy Act (42 U.S.C. 218(c)).
`A record from this system of records may be disclosed, as a routine use, to the Administrator,
`General Services, or his/her designee, during an inspection of records conducted by GSA as
`part of that agency’s responsibility to recommend improvements in records management
`practices and programs, under authority of 44 U.S.C. 2904 and 2906. Such disclosure shall
`be made in accordance with the GSA regulations governing inspection of records forthis
`purpose, and any other relevant (i.e., GSA or Commerce) directive. Such disclosure shall not
`be used to make determinations about individuals.
`
`A record from this system of records may be disclosed, as a routine use, to the public after
`either publication of the application pursuant to 35 U.S.C. 122(b) or issuance of a patent
`pursuant to 35 U.S.C. 151. Further, a record may be disclosed, subject to the limitations of 37
`CFR 1.14, as a routine use, to the public ifthe record was filed in an application which
`became abandoned or in which the proceedings were terminated and which application is
`referenced by either a published application, an application open to public inspection or an
`issued patent.
`A record from this system of records may be disclosed, as a routine use, to a Federal, State,
`or local law enforcement agency, if the USPTO becomes aware of a violation or potential
`violation of law or regulation.
`
`