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PROCESSING FEE TRANSMITTAL (USPTO)

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PTO/AIA/17p (10-20)
Approved for use through 12/31/2020. OMB 0651-0059
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
Enclosed is a petition filed under 37 CFR __________ that requires a processing fee (37 CFR 1.17(f), (g), or (h)).
Payment of $ __________ is enclosed.
This form should be included with the above-mentioned petition and faxed or mailed to the Office using the appropriate Mail Stop (e.g., Mail
Stop Petition), if applicable. For transmittal of processing fees under 37 CFR 1.17(i), see form PTO/SB/17i.
Applicant asserts small entity status. See 37 CFR 1.27.
Applicant certifies micro entity status. See 37 CFR 1.29.
Form PTO/SB/1 5A or B or equivalent must either be enclos ed or have b een s ubmitted previously.
Payment of Fees
The Commissioner is hereby authorized to charge the following fees to Deposit Account No. _______________:
petition fee under 37 CFR 1.17(f), (g) or (h) any deficiency of fees and credit of any overpayments
Check in the amount of $ _______________ is enclosed. Payment via EFS-Web.
Payment by credit card (Form PTO-2038 or equivalent is enclosed). Do not provide credit card information on this form.
Processing Fees Under 37 CFR 1.17(f):
Small Entity Fee $210 (Fee Code 2462) Micro Entity Fee $105 (Fee Code 3462) Undiscounted Fee $420 (Fee Code 1462)
For papers filed under:
§ 1.36(a) - for revocation of a power of attorney by fewer than all of the applicants.
§ 1.53(e) - to accord a filing date.
§ 1.182 - for decision on a question not specifically provided for in an application for patent.
§ 1.183 - to suspend the rules in an application for patent.
§ 1.741(b) - to accord a filing date to an application under § 1.740 for extension of a patent term.
§ 1.1023(b) - to review the filing date of an international design application.
Processing Fees Under 37 CFR 1.17(g):
Small Entity Fee $110 (Fee Code 2463) Micro Entity Fee $55 (Fee Code 3463)
Undiscounted Fee $220 (Fee Code
1463)
For papers filed under:
§ 1.12 - for access to an assignment record.
§ 1.14 - for access to an application.
§ 1.46 - for filing an application on behalf of an inventor by a person who otherwise shows sufficient proprietary interest in the matter.
§ 1.55(f) - for filing a belated certified copy of a foreign application.
§ 1.55(g) - for filing a belated certified copy of a foreign application.
§ 1.57(a) - for filing a belated certified copy of a foreign application.
§ 1.59 - for expungement of information.
§ 1.103(a) - to suspend action in an application.
§ 1.136(b) - for review of a request for extension of time when the provisions of § 1.136(a) are not available.
§ 1.377 - for review of decision refusing to accept and record payment of a maintenance fee filed prior to expiration of a patent.
§ 1.550(c) - for patent owner requests for extension of time in ex parte reexamination proceedings.
§ 1.956 - for patent owner requests for extension of time in inter partes reexamination proceedings.
§ 5.12 - for expedited handling of a foreign filing license.
§ 5.15 - for changing the scope of a license.
§ 5.25 - for retroactive license.
This collection of information is required by 37 CFR 1.17 . The information is required to obtain or retain a benefit by the public which is to file (and by the USP TO to
process) an application. Confidentiality is governed by 35 U.S.C. 122 and 37 CFR 1.14. This collection is estimated to take 5 minu tes to complete, including gathering,
preparing, and submitting the completed application 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 Information Officer, U.S. Patent and Trademark Office,
U.S. Department of Commerce, P .O. Box 1 450, Alexandria, VA 223 13-1450. DO NOT SEND FEES OR COMPLETED FORMS TO THIS ADDRESS. SEND TO: Commissioner
for Patents, P.O. Box 1450, Alexandria, VA 22313-1450 .
If you need assistance in completing the form, call 1-80 0-PTO-91 99 an d select option 2 .
PROCESSING FEE
Under 37 CFR 1.17(f), (g) & (h)
TRANSMITTAL
(Fees are subject to annual revision)
[Page 1 of 2]
Send completed form to: Commissioner for Patents, P.O. Box
1450, Alexandria, VA 22313-1450
Application Number
Filing Date
First Named Inventor
Art Unit
Examiner Name
Practitioner Docket No.
PTO/AIA/17p (10-20)
Approved for use through 12/31/2020. OMB 0651-0059
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
Processing Fees Under 37 CFR 1.17(h):
Undiscounted Fee $140 (Fee Code 1464) Small Entity Fee $70 (Fee Code 2464) Micro Entity Fee $35 (Fee Code 3464)
For papers filed under:
§ 1.19(g) - to request documents in a form other than provided in this part.
§ 1.84 – for accepting color drawings or photographs.
§ 1.91 – for entry of a model or exhibit.
§ 1.102(d) – to make an application special.
§ 1.138(c) - to expressly abandon an application to avoid publication.
§ 1.313 – to withdraw an application from issue.
§ 1.314 - to defer issuance of a patent.
PROCESSING FEE
Under 37 CFR 1.17(f), (g) & (h)
TRANSMITTAL
[Page 2 of 2]
SUBMI TTED BY
Signature
Registration No.
(Attorney/Agent)
Telephone
Name (Print/Type) Date
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
Inform ation 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 re cord 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.
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Completed 17 July 2021

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