Fee Transmittal

• Legal Form Number: SB/17
• Court: United States Patent and Trademark Office
• Section: United States Patent and Trademark Office

PTO/SB/17 (12-22)

Approved for use through 05/31/2024. OMB 0651-0032

U.S. Patent and Trademark Office; U.S. DEPARTMENT OF COMMERCE

Under the Paperwork Reduc tion Act of 1995 no persons are re quired to respond to a colle ction of information unles s it displays a valid OMB control n umber

FEE TRANSMITTAL

Complete if known

Application Number

Filing Date

Applicant asserts small entity status. See 37 CFR 1.27.

First Named Inventor

Applicant certifies micro entity status. See 37 CFR 1.29.

Form PTO/SB/15A or B o r equivalent must either be e nclosed or have

been submitted pre viously.

Examiner Name

Art Unit

TOTAL AMOUNT OF PAYMENT

($)

Practitioner Docket No.

METHOD OF PAYMENT (check all that apply)

Check Credit Card Money Order None Other (please identify): __________________ _________________________

Deposit Account Deposit Account Number: _____________________ __ Deposit Account Name: ______________________

For the above-identified deposit account, the Director is hereby au thorized to (check all that apply):

Charge fee(s) indicated below Charge fee(s) indicated below, except for the filing fee

Charge any additional fee(s) or underpayment of fee(s) Credit any overpayment of fee(s)

under 37 CFR 1.16 and 1.17

WARNING: Information on this form may become public. Credit card information should not b e included on this form. Provide credit card

information and authorization on PTO-2038.

FEE CALCULATION

1. BASIC FILING, SEARCH, AND EXAMINATION FEES (U = undiscounted fee; S = small entity fee; M = micro entity fee)

FILING FEES

SEARCH FEES

EXAMINATION FEES

Application Type

U ($)

S ($)

M ($)

U ($)

S ($)

M ($)

U ($)

S ($)

M ($)

Fees Paid ($)

Utility

320 128* 64 700 280 140 320 160

Design

220 88 44

160

64 32 256 128

Plant

220 88 44 440 176 88 264 132

Reissue

320 128 64 700 280 140 928 464

Provisional

300 120 60

0

0

0

800

640

660

2,320

0

0

0

* The $128 small entity filing fee for a utility application is further reduced to $64 for a small entity applicant who files the application via Patent Center or EFS-Web.

2. EXCESS CLAIM FEES

Fee Description

Undiscounted Fee ($)

Micro Entity Fee ($)

Each claim over 20 (including Reissues)

20

Each independent claim over 3 (including Reissues)

96

Multiple dependent claims

100

480

860

Small Entity Fee ($)

40

192

344 172

Total Claims

Extra Claims

Fee ($)

Fee Paid ($)

__________

-20 or HP =

__________ x

__________ =

__________

Multiple Dependent Claims

HP = highest number of total claims paid for, if greater than 20.

Fee ($)

Fee Paid ($)

Indep. Claims

Extra Claims

Fee ($)

Fee Paid ($)

__________

__________

__________

-3 or HP =

__________ x

__________ =

__________

HP = highest number of independent claims paid for, if greater than 3.

3. APPLICATION SIZE FEE

If the specification and drawings exceed 100 sheets of paper (excluding electronically filed sequence or computer listings under 37 CFR 1.52(e)),

the application size fee due is $420 ($168 for small entity) ($84 for micro entity) for each additional 50 sheets or fraction thereof. See 35 U.S.C.

41(a)(1)(G) and 37 CFR 1.16(s).

Total Sheets

Extra Sheets

Number of each additional 50 or fraction thereof

Fee ($)

Fee Paid ($)

__________ -100 =

__________ / 50 =

__________ (round up to a whole number) x

__________ =

__________

Fees Paid ($)

__________

__________

4. OTHER FEE(S)

Non-English specification, $140 fee ($56 for small entity) ($28 for micro entity)

Non-electronic filing fee under 37 CFR 1.16(t) for a utility application, $400 fee ($200 small or micro entity)

Other (e.g., late filing surcharge): ____________________________ ___________________________________________

__________

SUBMITTED BY

Signature

Registration No.

(Attorney/Agent)

Telephone

Name (Print/Type) Date

A Federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure to comply with an

information collection subject to the requirements of the Paperwork Reduction Act of 1995, unless the information collection has a currently valid OMB Control

Number. The OMB Control Number for this information collection is 0651-0032. Public burden for this form is estimated to average 30 minutes per response, i ncluding

the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the information

collection. Send comments regarding this burden estimate or any other aspect of this information collection, including suggestions for reducing this burden to the C hief

Administrative Officer, United States Patent and Trademark Office, P.O. Box 1450, Alexandria, VA 22313-1450 or email InformationCollection@uspto.gov. DO NOT

SEND FEES OR COMPLETED FORMS TO THIS ADDRESS. If filing this completed form by mail, send to: Commissioner for Patents, P.O. Box 1450, Alexandria, VA

22313-1450.

If you need assistance in completing the form, call 1-800-PTO-9199 and select option 2.