`Substitute for Form PTO-875
`
`Application or Docket Number
`16/150,919
`
`APPLICATION AS FILED - PART I
`Column 1
`(Column 2)
`
`SMALL ENTITY
`
`OTHER THAN
`SMALL ENTITY
`
`BASIC FEE
`(37 CFR1.16(a) (b) or (0))
`SEARCH FEE
`(37 CFR1.16(k) (i) or(m))
`
`(37 CFR1. 16(0
`EXAMINATION) FOEE»
`
`APPLICATION SIZE
`FEE
`(37 CFR1.16(s))
`
`If the specification and drawings exceed 100
`sheets of paper, the application size fee due is
`$310 ($155 for small entity) for each additional
`50 sheets or fraction thereof. See 35 U.S.C.
`41 (a)(1)(G) and 37 CFR1.16(s).
`
`MULTIPLE DEPENDENT CLAIM PRESENT (37 CFR 1.16(j))
`
`* lfthe difference in column 1
`
`is less than zero, enter ”0” in column 2.
`
`APPLICATION AS AMENDED - PART II
`
`CLAIMS
`REMAINING
`AFTER
`AMENDMENT
`
`(Column 3)
`
`(Column 2)
`HIGHEST
`NUMBER
`PREVIOUSLY
`PAID FOR
`
`ADDITIONAL
`FEE($)
`
`OTHER THAN
`
`SMALL ENTITY
`ADDITIONAL
`FEE($)
`
`Total
`(37 CFR1.16(i))
`Independent
`(37 OFR1. 16(h))
`
`Application Size Fee (37 CFR1.16(S))
`
`FIRST PRESENTATION OF MULTIPLE DEPENDENT CLAIM (37 CFR1.16(j))
`
`OLAIMS
`REMAINING
`AFTER
`AMENDMENT
`
`(Column 3)
`
`(Column 2)
`HIGHEST
`NUMBER
`PREVIOUSLY
`PAID FOR
`
`ADDITIONAL
`FEE($)
`
`ADDITIONAL
`FEE($)
`
`
`
`AMENDMENTA
`
`AMENDMENTB
`
`Total
`(37 OFR1. 16(i))
`Independent
`(37 OFR1. 16(h))
`Application Size Fee (37 CFR1.16(S))
`
`FIRST PRESENTATION OF MULTIPLE DEPENDENT CLAIM (37 CFR1.16(j))
`
`ADD'L FEE
`is less than the entry in column 2, write ”0” in column 3.
`* lfthe entry in column 1
`** lfthe ”Highest Number Previously Paid For” IN THIS SPACE is less than 20, enter ”20”.
`*** If the ”Highest Number Previously Paid For” IN THIS SPACE is less than 3, enter ”3”.
`The "Highest Number Previously Paid For" (Total or Independent) is the highest found in the appropriate box in column 1.
`
`TOTAL
`ADD'L FEE
`
`TOTAL
`ADD'L FEE
`
`
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