PT0-1382 (Rev. 01-2017)
Approved for use through 10/31/2022. OMB 0651-0021
U.S. Patent and Trademark Office; U.S. DEPARTMENT OF COMMERCE
Under the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number.
TRANSMITTAL LETTER TO THE UNITED STATES RECEIVING OFFICE (RO/US)
Priority Mail Express Mailing Label No.:
Date of Deposit:
File Reference No.:
International Application No. (If known):
Customer Number
1
:
Earliest Priority Date Claimed (dd/mm/yyyy):
Title of Invention:
Applicant:
1
Customer Number will allow access to the appl ication in Private PAIR but cannot be used to establish or change the correspondence address.
This is a new International Application
SCREENING DISCLOSURE INFORMATION:
In order to assist in screening the accompanying international application for purposes of determining whether a license for foreign transmittal should
and could be granted and for other purposes, the following information i s
supplied. (check all boxes as apply):
The invention disclosed was
not
made in the United States of America.
There is no prior U.S. application relating to this invention.
The following prior U.S. application(s) contain subject matter which is related to the invention disclosed in the attached international
application. (NOTE: priority to these applications may or may not be claimed on the
Request (form PCT/RO/101) and this listing does not
constitute a claim for priority.)
application no.
filed on
application no.
filed on
The present international application contains additional subject matter not found in the prior U.S. application(s) identified above. The
additional subject matter is found on pages________________________________________________
and
DOES NOT ALTER
MIGHT BE CONSIDERED TO ALTER the general nature of the
invention in a manner which would
require the U.S. application to have been made available for inspection by the
appropriate defense agencies under 35 U.S.C. 181 and
37 C.F.R. 5.15.
Itemized list of contents & entity status
Sheets of Request form:
Check no.:
Sheets of description
(excluding sequence listing):
Return receipt postcard:
Sheets of claims:
Power of attorney:
Sheets of abstract:
Certified copy of priority
document (specify):
Sheets of drawings:
PTO/SB15A or B or equivalent:
Sheets (paper or pdf) of sequence listing:
Other (specify):
uence listing text file: Seq
CD or diskette via EFS-Web
Applicant asserts small entity status. See 37 CFR 1.27. If this written assertion is made by the applicant, all applicants
must sign (37 C.F.R. §1.42)
Applicant certifies micro entity status. See 37 CFR 1.29. Applicant must attach form PTO/SB/15A or B or equivalent.
Applicant
Name of person signing
Attorney/Agent
Registration No.
Signature
Common Representative
This collection of infom1ation is required by 37 CFR 1.10 and 1.412. The information is required to obtain or retain a benefit by the public, which is to file (and by the
USPTO to process) an application. Confidentiality is governed by 35
U.S.C.
122 and 37 CFR 1.11 and 1.14. This collection is estimated to take 15 minutes to complete,
including gathering in formation, preparing, and submitting the completed form to the USPTO. Time will vary depending upon the individual case. Any comments on the
amount of time you require to complete this form and/or suggestions for reducing this burden, should be sent to the Chief I n f o r m a t i o n Officer, U.S. Patent and Trademark
Office, U.S. Department of Commerce, P.O. Box 1450, Alexandria, VA 22313- 1450. DO NOT SEND FEES OR COMPLETED FORMS TO THIS ADDRESS.
SEND TO: Mail Stop PCT, Commissioner for Patents, P.O. Box 1450, Alexandria, VA 22313-1450.
Page 1 of 1
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 attached form related to a patent application or patent. Accordingly,
pursuant to the requirements of the Act, please be advised that: (1) the general authority for the
collection of this information is 35 U.S.C. 2(b)(2); (2) furnishing of the information solicited is voluntary;
and (3) the principal purpose for which the information is used by the U.S. Patent and Trademark
Office is to 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 will be subject to the following routine uses:
1. The information on this form will be treated confidentially to the extent allowed under the
Freedom of Information Act (5 U.S.C. 552) and the Privacy Act (5 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 Freedom of Information Act.
2. A record from this system of records may be disclosed, as a routine use, in the course of
presenting evidence to a court, magistrate, or administrative tribunal, including disclosures to
opposing counsel in the course of settlement negotiations.
3. A record in this system of records may be disclosed, as a routine use, to a Member of
Congress submitting a request involving an individual, to whom the record pertains, when the
individual has requested assistance from the Member with respect to the subject matter of the
record.
4. A record in this system 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 shall be required to comply with the requirements of the Privacy Act of 1974, as
amended, pursuant to 5 U.S.C. 552a(m).
5. 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, pursuant to the Patent Cooperation Treaty.
6. A record in this system of records may be disclosed, as a routine use, to another federal
agency for purposes of National Security review (35 U.S.C . 181) and for review pursuant to
the Atomic Energy Act (42 U.S.C. 218(c)).
7. A record from this 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 responsibility to recommend improvements in records management
practices and 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 (i.e., GSA or Commerce) directive. Such disclosure shall not be used to
make determinations about individuals.
8. 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 35 U.S.C .122(b) or issuance of a patent
pursuant to 35 U.S.C. 151. Further, a record may be disclosed, subject to the limitations of 37
CFR 1.14, as a routine use, to the public if the record was filed in an application which became
abandoned or in 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.
9. A record from this system of records may be disclosed, as a routine use, to a Federal, State,
or local law enforcement agency, if the USPTO becomes aware of a violation or potential
violation of law or regulation.