Certification and Request to Place the Patent Assignment Abstract of Title into the Patent Application File

• Legal Form Number: SB/469
• Court: United States Patent and Trademark Office
• Section: United States Patent and Trademark Office

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Doc C ode: P.AS.V

Docume nt Des cription: Pate nts A ssig nment V erific ation re quest

PTO/ SB/469 (08-24)

CERTIFICATION AND REQUES T TO PLACE THE PATENT ASS IGNMEN T ABSTRA CT OF TI TLE INTO THE

PATENT APPLICATION FILE

Pra ctitioner Docke t No.:

Application No. :

Filing Da te:

Firs t Named Inve ntor:

Title:

APP LICANT HEREBY CERTIFIES THE FOLLOWING AND REQU ESTS THAT THE U SPTO PLACE THE

PATEN T ASSIG NMENT ABSTRAC T OF TITLE INTO THE ABOVE-IDENTIFIED PATENT APPLICATION

FILE.

1. This form is being filed by a pra ctitioner or the a pplicant for this application.

2. This form is being t ransmitted by electr onic mail t o RecordedAs sig nment Place ment@ us pto.gov.

3. This patent application is not open to the public.

4. Re cogniz ing that Inte rnet communi cat ions are not sec ure, I hereby author ize t he USPTO t o

communica te with the unders igned and prac titi oners in accordanc e with 37 CFR 1.33 and

37 CFR 1.34 concer ning any subject mat ter of this applic at ion by video confer encing , instant

mess ag ing, or elect ronic mail. I unders ta nd t hat a c opy of t hese communi cat ions wi ll be made

of recor d in t he appli cat ion file.

5. The unders igned request s that the Patent Assignment Abstract of Title for this applicat ion be

place d into the pat ent a pplica tion file.

Signa ture

Date

Pra ctitioner Re gistr ation No.

Name (Print/T yped)

Telephone Number

Note : T his form must be signed in accordance with 37 CFR 1.33. S ee 37 CFR 1.4(d) for signature requirem ents and certifications. Subm it multiple

forms if more than one signature is required, s ee below*.

* Total of forms are submitted.