Doc Code: WFEE
Document Description: Fee Worksheet (PTO-875)
PTO/SB/06 (03-13)
Approved for use through 01/31/2014. OMB 0651-0032
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.
PATENT APPLICATION FEE DETERMINATION RECORD |
Application or Docket Number |
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Substitute for Form PTO-875 |
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APPLICATION AS FILED - PART I |
LARGE ENTITY |
MICRO ENTITY |
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SMALL ENTITY |
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(Column 1) |
(Column 2) |
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FOR |
NUMBER FILED |
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NUMBER EXTRA |
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BASIC FEE |
N/A |
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N/A |
(37 CFR 1.16(a), (b), or (c)) |
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SEARCH FEE |
N/A |
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N/A |
(37 CFR 1.16(k), (i), or (m)) |
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EXAMINATION FEE |
N/A |
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N/A |
(37 CFR 1.16(o), (p), or (q)) |
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TOTAL CLAIMS |
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* |
(37 CFR 1.16(i)) |
minus 20 |
= |
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INDEPENDENT CLAIMS |
minus 3 |
= |
* |
(37 CFR 1.16(h)) |
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If the specification and drawings exceed 100 |
APPLICATION SIZE |
sheets of paper, the application size fee due |
FEE |
is $310 ($155 for small entity) for each |
(37 CFR 1.16(s)) |
additional 50 sheets or fraction thereof. See |
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35 U.S.C. 41(a)(1)(G) and 37 CFR 1.16(s). |
MULTIPLE DEPENDENT CLAIM PRESENT (37 CFR 1.16()))
* If the difference in column 1 is less than zero, enter "0" in column 2.
N/A
N/A
N/A
X=
X=
N/A
TOTAL
APPLICATION AS AMENDED - PART II
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(Column 1) |
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(Column 2) |
(Column 3) |
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CLAIMS |
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HIGHEST |
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AMENDMENTA |
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REMAINING |
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NUMBER |
PRESENT |
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AFTER |
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PREVIOUSLY |
EXTRA |
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AMENDMENT |
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PAID FOR |
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Total |
* |
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Minus |
** |
= |
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(37 CFR 1.16(i)) |
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Independent |
* |
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Minus |
*** |
= |
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(37 CFR 1.16(h)) |
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Application Size Fee (37 CFR 1.16(s)) |
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FIRST PRESENTATION OF MULTIPLE DEPENDENT CLAIM (37 CFR 1.16())) |
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(Column 1) |
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(Column 2) |
(Column 3) |
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CLAIMS |
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HIGHEST |
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AMENDMENTB |
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REMAINING |
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NUMBER |
PRESENT |
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AFTER |
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PREVIOUSLY |
EXTRA |
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AMENDMENT |
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PAID FOR |
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Total |
* |
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Minus |
** |
= |
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(37 CFR 1.16(i)) |
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Independent |
* |
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Minus |
*** |
= |
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(37 CFR 1.16(h)) |
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Application Size Fee (37 CFR 1.16(s)) |
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FIRST PRESENTATION OF MULTIPLE DEPENDENT CLAIM (37 CFR 1.16())) |
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LARGE ENTITY |
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MICRO ENTITY |
SMALL ENTITY |
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RATE ($) |
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ADDI- |
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TIONAL |
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FEE ($) |
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X |
= |
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X |
= |
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N/A |
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TOTAL |
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ADD'L FEE |
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RATE ($) |
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ADDI- |
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TIONAL |
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FEE ($) |
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X |
= |
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X |
= |
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N/A |
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TOTAL |
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ADD'L FEE |
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*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, 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: Commissioner for Patents, P.O. Box 1450, Alexandria, VA 22313-1450.
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