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`SUESTTTUTE STATEMENT TN: LSEU QF AN UATH {3R UECLARQTWN FUR UTELTW
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`SUBSTiTUTE $TATER§ENT
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`; Limiims‘tancias pcrmiiiing executian 9f {his substitute staiemeni:
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`C: Invemmris; afieceased
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`E invent-aria uncieriegai incaijaaiiy,
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`B An appiimtion {iata sheet Imisler 3? (“FR '35 {PTDIAINN (3r aqm‘maienfi has net been submitted Thus a Substiiute
`Statement Supniememai Sheet {PTQI'AIAIH or equivalent} naming ihe entire inveniive entity and pramding inventar
`ininrmaiicsn is. attached See 3? CPR 1.614(3)}.
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`WARMN‘E:
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`Signam:e:
`if the applicantis a juristio entiiy: iii-:3 the appiisantname and thatiil; (3f 33155331..
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`mem Packaging Tech naiogyi inc.
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`Appiicani Name:
`f Title of Pefsczn, Executing
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`; This Substituie Statement
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`Nate! U533 an addiiianai PTOMAJOZ icrrn far each invents; who Is 628588883 iegally incapacitated, cannat be Tillmd 9r fears.Ied
`after dii" em aff‘uri m has refused w execute ihe oath or deciaraiimn under 3? GFR 'i 83
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