Under the Paperwork Ri
`
`PTO/AIA/S6 (08-12)
`Approved for use through 01/31/2013. OMB 0651-0031
`
`US. Patel
`nt and Trademark Office: US. DEPARTMENT OF GOMMERCE
`tid OMB
`on Act of 1995, no persons are reguired te respond to a collection of information uniess it display
`
`SATEMENT UNDER 37 CFR 3.73(c)
`Justin Jensen
`
`Applicant/Patent Owner:
`Application No./Patent No., 84/678,845
`Titled: EMERGENCY CALL DATA ANALYTICS PLATFORM
`
`Fited/ssue Date, May 31, 2018
`
`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:
`
`_ of for which a copy thereof is attached. [Page 1 of 2]
`
`f
`
`(Name of Assignee}
`
`(Type of Assignee, ¢.g., corporation, parinersnip, university, government agency, etc.)
`
`| states that, for the patent application/patent identified above, itis (choose one of options 1, 2, 3 or 4 below):
`
`i.
`
`The assignee of ihe entire right, title, and interest.
`
`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:
`
`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.
`
`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}:
`
`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 at Reel,Frame@, of for which a copy
`thereof is attached.
`
`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: dustin Jensen
`To: RapidDeploy USA Corp.
`
`The document was recorded in the United States Patent and Trademark Office at
`046432
`, Frame 0482
`, of for which a copy thereof is attached.
`Reel
`RapidDepioy USA Corp.
`To. RapidDeploy, Inc.
`
`2. From:
`
`The document was recorded in the United States Patent and Trademark Office at
`Ree! 048414
`, Frame 0683
`
`oa
`
`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
`
`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
`
`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 burden, 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.
`
`ifyou need assistance in completing the form, call 1-800-PTO-9199 and select option 2.
`
`

`

`PTO/AIA/SE6 (08-12)
`Approved for use through 01/81/2013, OMB 0651-0031
`U.S. Patent and Trademark Office: U.S. DEPARTMENT OF COMMERGE
`
`i
`unless it displays a valid OMB control number.
`
`The document was recorded in the United States Patent and Trademark Office at
`
`ReelJFrame, or for which a copythereci is attached.
`
`The document was recorded in the United States Patent and Trademark Office at
`
`Reel
`
`, Frame
`
`, of for which a copy thereofis attached.
`
`To:
`
`The document was recorded in the United States Patent and Trademark Office at
`
`Reel
`
`, Frame
`
`, of for which a copy thereofis attached.
`
`To:
`
`
`
`The undersigned (whose title is supplied below) is authorized to act on behalf of the assignes.
`| ‘Caroline Greenwood/
`2/27/2019
`Signature
`| Caroline Greenwood
`
`The decument was recorded in the United States Patent and Trademark Office at
`
`Reel
`
`, Frame
`
`, of for which 4 copy thereofis attached.
`
`[]
`
`Additional documents in the chain of title are listed on a supplemental sheetis).
`
`[I
`
`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.
`
`INOTE: A separate copy (.e., a true copy of the original assignment docurnent(s)} must be submitted to Assignment
`Division in accordance with 37 CFR Part 3, to record the assignment in the records of the USPTO. See MPEP 302.08]
`
`Printed or Typed Narme
`
`Title or Registration Number
`
`[Page 2 of 2]
`
`

`

`Privacy Act Statement
`
`The Privacy Act of 1974 (P.L. 93-579) requires that you be given certain information in connection with your
`submission of the allached form related to a patent application or patent. Accordingly, pursuant to the
`requirements of the Act, please be advised that: (1) the general authority ior the collection of this information is 35
`U.S.C. 2(b}(2); (2) furnishing of the information solicited is voluntary; and (9) the principal purpose for which the
`information is usec by the U.S. Patent and Trademark Office is io process and/or examine your submission related
`to a patent application or patent.
`If you do not furnish the requested information, the U.S. Patent and Trademark
`Office may not be able to process and/or examine your submission, which may result in termination of proceedings
`or abandonment of the application or expiration of the patent.
`
`The information provided by you in this form willbe subject fo the following routine uses:
`
`t.
`
`nN
`
`&&
`
`The information on this form will be treated confidentially io the extent allowed uncer the Freeciom of
`Information Act (6 U.S.C. 552) and the Privacy Act (6 U.S.C 552a). Records from this system of records
`may be disclosed to the Department of Justice to determine whether disclosure of these records is
`required by the Freedorn of information Act.
`A record from this system of records may be disclosed, as a routine use, in the course of presenting
`evidence to a cour, magistrate, or administrative tribunal, including disclosures to opposing counsel in the
`course of settiament negotiations.
`A record in this system of records may be disclosed, as a routine use, io a Member of Congress
`submitting a request involving an individual, to whomthe record pertains, whenthe individual has
`requested assistance from the Member with respect to the sublect matter of the record.
`A record in this systern of records may be disclosed, as a routine use, to a contractor of the Agency
`having need for the information in order to perform a contract. Recipients of information shail oe required
`to comply with the requirements of the Privacy Act of 1974, as amended, pursuant to 5 ULS.C. 552a(m}.
`A record related to an International Application filed under the Patent Cooperation Treaty in this system of
`records may be disclosed, as a routine use, to the International Bureau of the World Intellectual Property
`Organization, oursuant to the Patent Cooperation Treaty.
`A record in this system of records may be disclosed, as a routine use, io another federal agency for
`purposes of National Security review (95 U.S.C. 181} and for review pursuant to the Atomic Energy Act
`(42 U.S.C. 218(c)).
`A record fromthis system of records may be disclosed, as a routine use, to the Administrator, General
`Services, or his/her designee, during an inspection of records conducted by GSA as part of that agency's
`resporisibility to recommend improvements in records management practices anc programs, under
`authority of 44 U.S.C. 2904 and 2906. Such disclosure shall be made in accordance with the GSA
`regulations governing inspection of records for this purpose, and any other relevant (Le., GSA or
`Gommercs} directive. Such disclosure shall not be used to make determinations about individuals.
`A record from this system of records may be disclosed, as a routine use, to the public after either
`publication of the application pursuant to $95 U.S.C. t22(b} or issuance of a patent pursuant to 35 U.S.C.
`151. Further, a record may be disclosed, subject to the limitations of 397 CFR 1.14, as a routine use, to the
`public H the record was filed in an application which became abandoned orin which the proceedings were
`terminated and which application is referenced by either a published application, an application open to
`public inspection or an issued patent.
`A record from this system of records may be disclosed, as a routine use, to a Federal, State, or local law
`enforcement agericy, if the USPTO becomes aware of a violation or potential viciation of law or regulation.
`
`

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