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`PTO/AIA/S6 (08-12)
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`tid OMB
`on Act of 1995, no persons are reguired te respond to a collection of information uniess it display
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`SATEMENT UNDER 37 CFR 3.73(c)
`Apolicant/Patent Owner. Medical Technologies CZ ais.
`Filed/issue Date; “uly 19, 2018
`| Application No./Patent No. _16/034,793
`AESTHETIC METHOD OF BIOLOGICAL STRUCTURE TREATMENT BY MAGNETIC FIELD
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`| Titled:
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`f
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`(Name of Assignee}
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`(Type of Assignee, ¢.g., corporation, parinersnip, university, government agency, etc.)
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`| states that, for the patent application/patent identified above, itis (choose one of options 1, 2, 3 or 4 below):
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`i.
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`The assignee of ihe entire right, title, and interest.
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`Additional Statement(s) by the owner(s) halding the balance of the interest musi be submitted to account for the entire
`right, title, and interest.
`i 3. [| The assignee of an undivided interest in the entirety (a complete assignment from one of the joint inventors was mace).
`| The other parties, inciuding inventors, who together own the entire right, title, and interest are:
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`2. [| An assignee ofless than the entire right, title, and interest (check applicable bax}:
`i| The extent (oy percentage) ofits ownership interastis%, Additional Statement(s) by the owners
`noiding the balance of the interest must be submitted to account for 100%of the ownership interest.
`[ There are unspecified percentages of ownership. The other parties, including inventors, who together own the entire
`fM7
`right, title and interest are:
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`_ of for which a copy thereof is attached. [Page 1 of 2]
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`right, title, and interest.
`4. [] The recipient, via a court proceeding orthe like (¢.¢., bankruptcy, probate), of an undivided interest in the eritirety (a
`| complete transfer of ownership interest was made). The certified document(s) showing the transferis attached.
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`The interest identified in option 1, 2 or 3 above (not option 4) is evidenced by either (choose one of options A or B below}:
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`A. [I An assignment from the inventor(s) of the patent application/patent identified above. The assignment was recorded in
`the United States Patent and Trademark Office atReel,Frame@, of for which a copy
`thereof is attached.
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`5. [v A chain of tte from the inventor(s), of the patent appiication/patent identified above, to the current assignee as follows:
`4. From: SCHWARZet al
`To: GL industries Ltd.
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`The document was recorded in the United States Patent and Trademark Office at
`G46566
`, Frame 0665
`, of for which a copy thereof is attached.
`Reel
`BTL Industries Lid.
`To, Medical Technologies CZ a.s.
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`2. From:
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`The document was recorded in the United States Patent and Trademark Office at
`Ree! 048200
`, Frame 0191
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`oa
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`This catlection of information Is required by 37 GFR 3.73(b). The information is required to obtain ar retain a benefit by the public whichis to tile (and by the USPTO to
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`ated to take 12 mi
`process} an application. Contideniiality is governed by 35 U.S.C. 122 and 37 CFR 1.41 and 1.14. This collection is estim
`inutes to complete, including
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`gathering, preparing, and submitting the completed application form ta the USPTO. Time will vary depending uponthe individual case. Any comments on the amount
`tn
`oi time you require to complete this form and/or suggestions for reducing this ourden, should be sent to the Chief information Officer, U.S. Patent and Trademark
`Office. U.S. Department of Gomm
`erce, P.O. Box 1450, Alexandria, VA 22313-1450. DO NOT SEND FEES OR COMPLETED FORMS TO THIS ADDRESS. SEND
`7G: Commissioner tor Patents, P.O. Box 1456, Alexandria, VA 22313-1450.
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`ifyou need assistance in completing the form, call 1-800-PTO-9199 and select option 2.
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`The cocument was recorded in the United States Patent and Trademark Office at
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`ReelJFrame, or for which a copythereci is attached.
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`4, From:
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`The cocument was recorded in the United States Patent and Trademark Office at
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`, of for which a copy thereofis attached.
`, Frame
`Reel
`To:
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`The document was recorded in the United States Patent and Trademark Office at
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`The decument was recorded in the United States Patent and Trademark Office at
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`Reel
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`, Frame
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`, of for which 4 copy thereofis attached.
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`[]
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`Additional documents in the chain of title are listed on a supplemental sheetis).
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`, of for which a copy thereofis attached.
`, Frame
`Reel
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`To:
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`fy)
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`;
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`As required by 37 CFR 3.73tc)(1}(), the documentary evidence of the chain of tile framthe original ownerto the
`assignee was, or concurrently is being, submitted for recordation pursuant to 37 CFR 3.11.
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`INOTE: A separate copy (Le., a tue copy of the original assignment docurnent(s)) must be submitted to Assignment
`Division in accordance with 07 CFR Part 3, to record the assignment in the records of the USPTO. See MPEP 302.08]
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`The undersigned (whose title is suoplied below} is authorized to act on behalf of the assignee.
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`| /Richard D. Coller Ili/
`| Signature
`Richard D. Coller Ill
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`Printed or Typed Name
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`:
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`April 22, 2019
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`[Page 2 of 2]
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`Title or Registration Number
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