PATENT APPLICATION FEE DETERMINATION RECORD
`Substitute for Form PTO-875
`
`Application or Docket Number
`18/250,921
`
`APPLICATION AS FILED - PART|
`(Column 1)
`(Column 2)
`NUMBER FILED
`NUMBER EXTRA
`
`SMALL ENTITY
`RATE($
`
`OTHER THAN
`SMALL ENTITY
`RATE($)
`FEE($)
`
`(37 CFR 1.16(0.
`
`N/A
`
`<>
`
`<>
`
`If the specification and drawings exceed 100
`APPLICATION SIZE_|sheets of paper, the application size fee due is
`FEE
`$310 ($155 for small entity) for each additional
`(37 CFR 1.16(s))
`50 sheetsor fraction thereof. See 35 U.S.C.
`41(a)(1)(G) and 37 CFR 1.16(s).
`
`MULTIPLE DEPENDENT CLAIM PRESENT(37 CFR 1.16(j))
`
`* If the difference in column 1
`
`is less than zero, enter "O" in column 2.
`
`APPLICATION AS AMENDED - PARTII
`
`BASIC ec)
`(37 CFR 1.16(a
`SEARCH a
`EXAMINATIONFEE
`TOTALCLAWS
`INDEPENDENT CLAIMSeea
`
`the appropriate box i
`
`AMENDMENTA
`
`AMENDMENTB
`
`(Column 1)
`CLAIMS
`REMAINING
`AFTER
`AMENDMENT
`
`(Column 3)
`
`(Column 2)
`HIGHEST
`NUMBER
`PREVIOUSLY
`PAID FOR
`
`Minus
`
`SMALL ENTITY
`ADDITIONAL
`FEE($)
`
`Total
`(37 CFR 1.16(i))
`
`(37 CFR 1.16(h))
`
`Application Size Fee (37 CFR 1.16(s
`
`OTHER THAN
`SMALL ENTITY
`ADDITIONAL
`FEE($)
`
`FIRST PRESENTATION OF MULTIPLE DEPENDENTCLAIM (37 CFR 1.16(j))
`
`(Column 1)
`CLAIMS
`REMAINING
`AFTER
`AMENDMENT
`
`(Column 3)
`
`(Column 2)
`HIGHEST
`NUMBER
`PREVIOUSLY
`PAID FOR
`
`+ _ |Minus
`snleanon 8Size Fee (37 CFR 1.16(s
`FIRST PRESENTATION OF MULTIPLE DEPENDENTCLAIM (37 CFR 1.16(j))
`
`TOTAL
`ADD'L FEE
`is less than the entry in column 2, write "0" in column 3.
`* If the entry in column 1
`* If the "Highest Number Previously Paid For" IN THIS SPACE is less than 20, enter "20".
`* If the "Highest Number Previously Paid For" IN THIS SPACEis less than 3, enter "3".
`he "Highest
`Number Previo
`Paid
`For"
`(Tots
`on
`ndependent)
`is
`the highest
`found in
`
`ADDITIONAL
`FEE($)
`
`ADDITIONAL
`FEE($)
`
`

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