PTO/SB/06 (07-06)
`Approved for use through 1/31/2007. OMB 0651-0032
`US. Patent and Trademark Office; US. DEPARTMENT OF COMMERCE
`Under the Paoerwork Reduction Act of 1995, no oersons are reouired to resoond to a collection of information unless it disola s a valid OMB control number.
`
`PATENT APPLICATION FEE DETERMINATION RECORD
`Substitute for Form PTO-875
`
`Application or Dockei Number
`12/446,115
`
`Fiiing Daie
`
`[I To be Mailed
`
`APPLICATION AS FILED — PART I
`
`OTHER THAN
`
`(Column 1)
`
`(Column 2)
`
`SMALL ENTITY |:|
`
`OR
`
`SMALL ENTITY
`
`—
`
`37 CFR 1.16 a ,
`
`b,orc
`
`I] SEARCH FEE
`37 CFR1. 16 k
`
`iorm
`
`I:I EXAMINATIONpFEoE(q
`37 CFR1. 16i
`
`37 CFR1.16 n
`
`DAPPLICATION SIZE FEE
`(37 CFR1.16(s))
`
`——
`““1520:
`—
`”W153—
`If the specification and drawings exceed 100
`sheets of paper, the application size fee due
`iS $250 ($125 for small entity) for each
`additional 50 sheets or fraction thereof. See
`35 U.S.C. 41 a 1 G and 37 CFR 1.16 S.
`
`[I MULTIPLE DEPENDENT CLAIM PRESENT (37 CFR1.16(j))
`* If the difference in column 1 is less than zero, enter“0" in column 2.
`
`APPLICATION AS AMENDED — PART II
`
`— —
`
`SMALL ENTITY
`
`OR
`
`SMALL ENTITY
`
`OTH ER THAN
`
`/ANGELA WHITE/
`
`(Column 1)
`CLAIMS
`REMAINING
`AFTER
`
`12/28/2009
`
`(Column 2)
`HIGHEST
`NUMBER
`PREVIOUSLY
`PAID FOR
`
`(Column 3)
`
`PRESENT
`EXTRA
`
`ADDITIONAL
`FEE ($)
`
`RATE ($)
`
`Total (37 CFR
`1.16I
`Independent
`37 CFR 1.16 h
`
`A_MENDMENT
`
`Minus
`
`Minus
`
`_ m
`X 69
`
`ll
`
`El Application Size Fee (37 CFR 1. 16(s))
`
`D FIRST PRESENTATION OF MULTIPLE DEPENDENT CLAIM (37 CFR1.16(j))
`
`ADDITIONAL
`FEE ($)
`
`RATE (19)
`
`$52:
`
`$220:
`
`(Column 1)
`CLAIMS
`REMAINING
`AFTER
`
`(Column 2)
`HIGHEST
`NUMBER
`PREVIOUSLY
`PAID FOR
`
`(Column 3)
`
`PRESENT
`
`RATE ($)
`
`ADDITIONAL
`FEE ($)
`
`RATE ($)
`
`ADDITIONAL
`FEE (53)
`
`Total (37 CFR
`1.16i
`Independent
`37 CFR 1.16 h
`
`A_MENDMENT
`
`Minus
`
`Minus
`
`D Application Size Fee (37 CFR 1. 16(s))
`
`D FIRST PRESENTATION OF MULTIPLE DEPENDENT CLAIM (37 CFR1.16(j))
`
`XX 6969
`
`XX 6969
`
`OR
`
`OR
`
`TOTAL
`ADD‘L
`FEE
`
`* If the entry in column 1 is less than the entry in column 2, write “0" in column 3.
`** If the “Highest Number Previously Paid For" IN THIS SPACE is less than 20, enter “20".
`*** If the “Highest Number Previously Paid For" IN THIS SPACE is less than 3, enter “3‘.
`The “Highest Number Previously Paid For" (Total or Independent) is the highest number found in the appropriate box in column 1.
`This collection of information is required by 37 CFR 1.16. 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 1.14. This collection is estimated to take 12 minutes 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, US. Patent and Trademark Office, US.
`Department of Commerce, PO. Box 1450, Alexandria, VA 22313-1450. 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 1-800-PTO-9199 and select option 2.
`
`Legal Instrument Examiner:
`
`'—
`IJ
`
`ZL
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`EDZL
`
`IJ
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`E<
`
`AMENDMENT
`
`