PTO/AIN01 (06-12)
`Approved for use through 01/31/2014. OMB 0651—0032
`US. Patent and Trademark Otfice; US. DEPARTMENT OF COMMERCE
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`.As the below named inventor, I hereby declare that:
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`United States application or PCT international application number PCT/JP2018/015845
`filed on Aprrl 17» 2018
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`The above-identified application was made or authorized to be made by me.
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`I believe that i am the original inventor or an original joint inventor of a claimed invention in the application.
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`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.
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`Petitioner/applicant is cautioned to avoid submitting personal information in documents filed in a patent application that may contribute to identity 1
`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 ~
`pt’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
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`USPTO to process) an application. Ccafiflsm
`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 iiSPTO. Time will vary depending upon the individual case. Any comments on the amount
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`Ifyou need assistance in completing the form, call 1-800-PTO-9199 and select option 2.
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