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PTO/SB/26a (02-14)
`Approved for use through 11/30/2020. OMB 0651-0031
`U.S. Patent and Trademark Office; U.S. DEPARTMENT OF COMMERCE
`Underthe Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unlessit displays a valid OMB control number.
`Docket Number (Optional)
`
`TERMINAL DISCLAIMER IN A PATENT OR PROCEEDING
`IN VIEW OF ANOTHER PATENT
`
`4387.00400G0
`
`Application/Control Number: 1 6/674,1 44
`Filing Date: 11/05/2019
`First Named Inventor: Tomas SCHWARZ
`Title: Aesthetic Method of Biological Structure Treatment by Magnetic Field
`Patent No.. 10.695.576
`
`percentinterest in the instant patent hereby
`, ownerof 100
`The patentee, BTL Medical Technologies S.R.O.
`disclaims, except as provided below, the terminal part of the statutory term of the instant patent which would extend beyond the expiration
`date ofthe full statutory term of patent No.
`| QO 709 894
`(the “reference patent”), as the term of said reference patent is presently
`shortened by any terminal disclaimer. The patentee hereby agrees that the instant patent shall be enforceable only for and during such period
`that the instant patent and the reference patent are commonly owned. This agreement runs with the instant patent and is binding upon the
`grantee, its successorsor assigns.
`
`In making the above disclaimer, the patentee does not disclaim the terminal part of the instant patent that would extend to the expiration date
`of the full statutory term of the reference patent, “as the term of said reference patent is presently shortened by any terminaldisclaimer,”in
`the event that said reference patent later: expires for failure to pay a maintenance fee; is held unenforceable; is found invalid by a court of
`competentjurisdiction; is statutorily disclaimed in whole or terminally disclaimed under 37 CFR 1.321; has all claims canceled by a
`reexamination certificate; is reissued; or is in any mannerterminatedprior to the expiration ofits full statutory term as shortened by any
`terminal disclaimer.
`
`|. Checkeither box 1, 2, or 3 below, as appropriate, if there is an assignment:
`
`
`|__| The current ownership was established bythe filing of a statement under 37 CFR 3.73 during prosecution of the application that
`1.
`issued asthe instant patent.
`
`be included on this form. Provide credit card information and authorization on PTO-2038.
`
`
`
`
`2. |“|The instant patent was issued from an application filed on or after September 16, 2012, and the current patent owner wasthe
`
`applicant under 37 CFR 1.46.
`
`3. [| A statement under 37 CFR 3.73 is attached herewith. Form PTO/SB/96 or PTO/AIA/96, as appropriate, may be used.
`
`IL. Authorization for Terminal Disclaimer - Check either box 1 or 2 below, if appropriate:
`
`| hereby acknowledge that any willful false statements made are punishable under 18 U.S.C. 1001 byfine or imprisonment of not
`more thanfive (5) years, or both.
`
`For submissions on behalf of a business/organization (e.g., corporation, partnership, university, government agency,etc.), the
`undersigned is empoweredto act on behalf of the business/organization.
`
` The undersigned is an attorney or agent of record. Reg. No. 60390
`
`
`
`/Richard D. Coller III/
`
`Signature
`
`Richard D. Coller Ill
`
`March 17, 2021
`Date
`
`202-371-2600
`
`Typed or printed name
`
`Telephone number
`
`
`| The terminal disclaimer fee under 37 CFR 1.20(d)is included.
`
`NOTE: Submit multiple forms if more than one signature is required, see below.*
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`WARNING: Information on this form may become public. Credit card information should not
`
`forms are submitted.
`*Total of 1
`This collection of information is required by 37 CFR 1.321. The information is required to obtain or retain a benefit by the public, which isto 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 12 minutes to complete,
`including gathering, preparing, and submitting the completed application form to the USPTO. Timewill vary depending uponthe individual case. Any comments on
`the amountof time you require to complete this form and/or suggestions for reducing this burden should be sentto 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 FORMS TO THIS
`ADDRESS. SEND TO: Commissionerfor Patents, P.O. Box 1450, Alexandria, VA 22313-1450.
`
`ff you need assistance in completing the form, call 1-800-PTO-9199 and select option 2.
`
`

`

`Privacy Act Statement
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`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
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`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 abandonmentof the
`application or expiration of the patent.
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`The information provided by you in this form will be subject to the following routine uses:
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`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
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`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
`wasfiled in an application which became abandonedor in which the proceedings were terminated and which
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`enforcement agency, if the USPTO becomes awareof a violation or potential violation of law or regulation.
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