REGISTERED PRACTITIONERS
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`Title
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`AUTOINJECTOR
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`——
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`
`
`Attorney Docket Number
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`46567-0349002
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`SIGNATURE of A . . licant or Patent Practitioner
`
`/A|ex Yu/
`
`Alex Yu
`
`Name
`
`Title (if Applicant is a
`juristic entity)
`
`Applicant Name (if Applicant is a juristic entity)
`
`Date (Optional)
`
`Registration
`Number
`
`74,295
`
`NOTE: This form must be signed in accordance with 37 CFR 1.33. See 37 CFR 1.4(d) for signature requirements and certifications. If
`more than one applicant, use multiple forms.
`
`IXI
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`*Total of
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`1
`
`forms are submitted.
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`23873470.doc
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`

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