Equivalent to PTO/AIA/96 (08-12)
`Approved for use through 01/31/2013. OMB 0651-0031
`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.
`
`Attorney Docket No. 256032-0005CP2C1
`
`STATEMENT UNDER 37 CFR 3.73(c)
`
`Applicant/Patent Owner:
`
`Application No./Patent No.:
`
`
`Hamamatsu Photonics K.K.
`
`_13/099,823
`Filed/Issue Date:
`_May 3, 2011
`
`Titled:
`
`
`Laser-Driven Light Source
`
`
`
`
`
`
`
`Hamamatsu Photonics K.K. ,a_corporation
`(Name of Assignee)
`(Type of Assignee, e.g. corporation, partnership, university, government agencyetc.)
`
`states that, for the patent application/patent identified above, it is (choose one of options 1, 2, 3 or 4 below):
`1. Xx The assigneeof the entire right, title and interest.
`2. C An assignee of less than the entire right, title and interest
`(check applicable box):
`%. Additional Statement(s) by the owners holding the
`L] The extent (by percentage)of its ownershipinterestis
`balanceof the interest must be submitted to account for 100% of the ownership interest.
`
`
`
`[] There are unspecified percentages of ownership. The other parties, including inventors, who together ownthe entire
`right, title and interest are:
`
`
`
`Additional Statement(s)} by the owner(s) holding the balance of the interest must be submitted to accountfor the entire
`right, title and interest.
`3.(.] The assigneeof an undivided interest in the entirety (a complete assignmentfrom oneofthe joint inventors was made). The
`other parties, including
`inventors, who together own the entire right, title and interest are:
`
`
`
`Additional Statement(s)} by the owner(s) holding the balance of the interest must be submitted to accountfor the entire
`right, title and interest.
`4.L] The recipient, via a court proceeding or the like (e.g., bankruptcy, probate), of an undivided interest in the entirety (a
`complete transfer of ownership interest was made}. The certified document(s) showing the transfer is attached.
`
`The interest identified in option 1, 2 or 3 above (not option 4) is evidenced byeither (choose one of options A or B below):
`A.L_] An assignmentfrom the inventor(s) of the patent application/patent identified above. The assignment was recordedin the
`United States Patent and Trademark Office at Reel
`, Frame
`, or for which a copy thereof is attached.
`
`B. XX] Achain oftitle from the inventor(s), of the patent application/patent identified above, to the current assignee asfollows:
`
`1.
`
`From:
`
`Smith, et al.
`
`To:
`
`_Energetiq Technology, Inc.
`
`The document was recorded in the United States Patent and Trademark Office at
`
`Reel
`
`026828
`
`, Frame
`
`0616
`
`, of for which a copy thereofis attached.
`
`2.
`
`From:
`
`Energetig Technology, Inc.
`
`To:
`
`_Hamamatsu Photonics K.K.
`
`The document was recorded in the United States Patent and Trademark Office at
`
`Reel
`
`048380
`
`, Frame
`
`0084
`
`, of for which a copy thereofis attached.
`
`[Page 1 of 2]
`This collection of information is required by 37 CFR 1.53(b). The information is required to obtain or retain a benefit by the public whichis tofile (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 amountof 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 TrademarkOffice, U.S.
`Department of Commerce, P.O. Box 1450, Alexandria, VA 22313-1450. DO NOT SEND FEES OR COMPLETED FORMSTO THIS ADDRESS. SEND TO: Commissioner
`for Patents, P.O. Box 1450, Alexandria, VA 22313-1450.
`
`lf you need assistance in completing the form, call 1-800-PTO-9199 and select option 2.
`
`

`

`Equivalent to PTO/AIA/96 (08-12)
`Approved for use through 01/31/2013. OMB 0651-0031
`U.S. Patent and Trademark Office. U.S. DEPARTMENT OF COMMERCE
`
`STATEMENT UNDER 37 CFR 3.73(c)
`
`3.
`
`From:
`
`To:
`
`The document was recorded in the United States Patent and Trademark Office at
`
`Reel
`
`4.
`
`From:
`
`, Frame
`
`To:
`
`, of for which a copy thereofis attached.
`
`The document was recorded in the United States Patent and Trademark Office at
`
`
`
`Under the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unlessit displays a valid OMB control number.
`
`Reel
`
`5.
`
`From:
`
`, Frame
`
`To:
`
`, of for which a copy thereofis attached.
`
`The document was recorded in the United States Patent and Trademark Office at
`
`Reel
`
`6.
`
`From:
`
`, Frame
`
`To:
`
`, of for which a copy thereofis attached.
`
`The document was recorded in the United States Patent and Trademark Office at
`
`Reel
`
`, Frame
`
`, of for which a copy thereofis attached.
`
`L]
`
`Additional documents in the chain oftitle are listed ona supplemental sheet(s).
`
`XK
`
`As required by 37 CFR 3.73(c)(1)(i), the documentary evidence of the chain oftitle from the original owner to the
`assignee was, or concurrently is being, submitted for recordation pursuant to 37 CFR 3.11.
`
`(NOTE: A separate copy(i.e., a true copy of the original assignment document(s}) must be submitted to Assignment
`Division in accordance with 37 CFR Part 3, to record the assignment in the records of the USPTO. See MPEP 302.08)
`
`The undersigned (whosetitle is supplied below) is authorized to act on behalf of the assignee.
`
`/ Gerald E. Worth, #45,238 /
`Signature
`
`Gerald E. Worth
`Printed or Typed Name
`
`11, 2024
`
`July
`Date
`
`45,238
`Title or Registration Number
`
`[Page 2 of 2]
`
`