Blanket Nil: 122328~53t32
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`APPLiCATlQN BATA $HEET (3? CFR “135}
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`Title at
`invention
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`lNJECTlQN BEVlCE
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`As the below named inventor, l hereby declare that:
`
`thin declaration m The attract-lad anplinatlnn. nr
`is directed to:
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`
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`United Staten applicatinn nr PCT internalinnal applicatinn nu miter
`tiled (in
`Marsh '39. 2019
`
`ififfifififififi
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`The aheveééeniifieci application was made nranthnrizad in be made by me.
`
`l battens that i am ”ma nrlglnal inventor nr an criginal taint lnvantnr nt a claimed inventian in the application.
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`l hereby admowledge that any willful false statement made in this declaratinn is punishable under iii USE. 1 {Jill
`by fine nr imprisonment at not more than five (5} years, nr both.
`
`l acknawiange the duty to disnlnse in the Unitan {attains Patent anti Trademark Office all lnformatinn known in me to be
`mEaterlai in natantahility as defined in 3'? CFR 1.56, including for continuation-in~nan applicatinnni material ininrniaiion which
`hexane availabie between the filing date at the prim application and the natinnal or PCT international filing date at the
`cantinuatiun-in—part application“
`
`l authorize and request the practitioners appointed in the aliens-identified application in insert the filing date and applicalinn
`number at the appliwtinn, whnn knnwn. andinr shank the anpmpriata bin-z.
`
`WARNER-i:
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`Patitinnerfapplicant is sentiment in amid aubmitting personal ininr‘matien in dawrnenta tiled in a patent applimtinn that may
`contribute to identity than; Perennal intermatiun such an encial necurity numbers, bank acouunt numbers, or credit card numbers
`{other than a chew at credit card authen‘zation form PTOQOSS submitted for payment purposes} is never required by the USPTO
`to suppurt a paliiian or an anplinatton. if this type of personal iniorrnatinn is included in (Streams-ants submitted in the USP‘TU,
`neiifinnerei’applinania should consider redacting such personal information from the dean merits before submitting them to the
`UEF’TU. Petitionerl’applicant is advised that the rennni at a patent application is available tn the public after nu bliaalinn of the
`application {unless a non—pnttikratinn request in compliance with 3? (FR 1.21%?) in made: in the applicatiun) Dr isnuance at a
`patent. Farina-mare: the recnrd from an abandoned application may else be available to the public tithe applicatinn is
`ra’ierenceri in a published applicatinn or an issued QEiEflt {see 3? CFR 1,14). Checks and {radii nerd authnrtzatinn tonne
`Fifi-2538 wilmitted tor payment purposes are. not retained in the application tile and therefnre are net publicly available.
`
`LEGAL NAME OF SNVENTOR
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`inventor:
`Signature;
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`Christggliar S, MUBB
`MM "‘n
`I MM {if
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`Date {Optimal}: 5?? Eighth gig!”
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`i i Q? '5“; if
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`Note: An applinaticm data sheet {PTOiSBi‘M Dr equivalent), including naming the entire inventive Emily, must ancmnpany this farm 03'
`must have been previously filed. Use an additional ciaciaraiinn term tar each additional inveninr.
`
`Declaratien
`D32; SGMBIIUJ
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`[2318mm]
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