CAN: 33:42$‘w\«z\\< 6266313 «.335?\ 3&3?)- a") 33 ’
`
`"
`
`332:3 3:3
`3833833333333
`
`£353 3m-wésw 335333333333 8
`
`“£3333: 3333332333333
`3 333363333631 3'85
`
`[”3
`“N-w\\\\\s
`
`\\\\\\"‘""""’“.
`
`
`
`“mazeamhwn. 3»
`mm63333333 3:3
`
`'
`
`®+§xerap§ H
`3.33636 3983*
`
`, “3363:3331 :33 33313233333333. £3338
`" "
`'
`{:3
`3.333%
`
`‘
`
`~
`
`:
`
`2
`
`:
`
`mam-3:3,
`
`u:
`”his
`1.
`..
`.
`,3; M}.
`’3‘ $&)Q}R‘m“:3 ‘
`_
`.
`33>. 63:336.SE63}333 {39333336619316far 33mm. 3*.33. 3:31:33:333%,6333332353333'36“ 33363333
`
`

`

`DocuSign Envetope lD' A306AE9F-34D6-45C1~8A39—SBE65D79F360E
`
`PTO/AIA/O1 (06—12)
`Approved for use through 01/31/2014. OMB 0651-0032
`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.
`
`DECLARATION (37 CFR 1.63) FOR UTILITY OR DESIGN APPLICATION USING AN
`APPLICATION DATA SHEET (37 CFR 1.76)
`
`Title of
`Invention
`
`SAMPLE PREPARATION METHODS, SYSTEMS AND COMPOSITIONS
`
`As the below named inventor, I hereby declare that:
`
`This declaration Cl
`is directed to:
`
`The attached application, or
`
`United States application or PCT international application number 15/952,203
`
`filed on Am” 12, 2018
`
`The above—identified application was made or authorized to be made by me.
`
`I believe that I am the original inventor or an original joint inventor of a claimed invention in the application.
`
`I hereby acknowledge that any willful false statement made in this declaration is punishable under 18 U.S.C. 1001
`by fine or imprisonment of not more than five (5) years, or both.
`
`
`
`WARNING:
`
`Petitioner/applicant is cautioned to avoid submitting personal information in documents filed in a patent application that may
`contribute to identity theft. Personal information such as social security numbers, bank account numbers, or credit card numbers
`(other than a check or credit card authorization form PTO—2038 submitted for payment purposes) is never required by the USPTO
`to support a petition or an application.
`If this type of personal information is included in documents submitted to the USPTO,
`petitioners/applicants should consider redacting such personal information from the documents before submitting them to the
`USPTO. Petitioner/applicant is advised that the record of a patent application is available to the public after publication of the
`application (unless a non—publication request in compliance with 37 CFR 1.213(a) is made in the application) or issuance of a
`patent. Furthermore, the record from an abandoned application may also be available to the public if the application is
`referenced in a published application or an issued patent (see 37 CFR 1.14). Checks and credit card authorization forms
`PTO-2038 submitted for payment purposes are not retained in the application file and therefore are not publicly available.
`
`LEGAL NAME OF INVENTOR
`
`inventor:
`
`
`Rene Sit
`,—Dowslgned by
`.___ Nasal/54951415
`Signature: j few/Wt
`
`Date (Optional) :
`
`4/13/2018
`
`Note: An application data sheet (PTO/AIA/14 or equivalent), including naming the entire inventive entity, must accompany this form.
`Use an additional PTO/SB/AIAO1 form for each additional inventor.
`
`This collection of information is required by 35 U.S.C. 115 and 37 CFR 1.63. 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 1 minute 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, U.S.
`Patent and Trademark Office, U.S. 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.0. Box 1450, Alexandria, VA 22313—1450.
`If you need assistance in completing the form, call 1-800-PTO-9199 and select option 2.
`
`

`

`i 3% {m ppépw {$332}ch{amp
`
`EE33» sfipgérsr‘ "psi 5“
`ml
`.ffit‘ififi m:
`‘w-J'i
`
`am ship
`
`pesiwt
`3
`"
`w‘ew‘ppw} En p pi: Emmi mpkm 333iiiam
`
`' ‘
`
`rmiiiippgi;ianiépép-gppm'mg mi: pipis’ip'pififiéfiippppiigg3mp
`“'
`"
`
`ppm; N
`
`mirppipi:
`
`'
`
`rshwu‘? " Z " ""
`Nm’p: Mpgpmpmdfi
`539;?!an pairinmmi “Ekmififiskkfi sum {iii pix
`
`