Form PTO SB 17 is an important document for employers and employees in the state of California. This form allows employers to designate paid time off (PTO) for their employees, and sets the rules for how that PTO can be used. Employees should familiarize themselves with this form so they know their rights and employer's expectations. Employers should also familiarize themselves with Form PTO SB 17, so they can ensure they are complying with the law. Whether you're an employee or an employer, make sure you read and understand Form PTO SB 17 before taking action!
Question | Answer |
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Form Name | Form Pto Sb 17 |
Form Length | 2 pages |
Fillable? | No |
Fillable fields | 0 |
Avg. time to fill out | 30 sec |
Other names | CFR, 1-800-PTO-9199, underpayments, GSA |
PTO/SB/17#(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#
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FEE#TRANSMITTAL# |
Complete#if#known# |
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Application#Number |
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Filing#Date |
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Applicant#asserts#small#entity#status.#See#37#CFR#1.27.# |
First#Named#Inventor |
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Applicant#certifies#micro#entity#status.#See#37#CFR#1.29. |
Examiner#Name |
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Form#PTO/SB/15A#or#B#or#equivalent#must#either#be#enclosed#or#have# |
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Art#Unit |
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#########been#submitted#previously.# |
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TOTAL#AMOUNT#OF#PAYMENT# |
($)# |
Practitioner#Docket#No. |
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METHOD#OF#PAYMENT#(check#all#that#apply)#
########Check###########Credit#Card###########Money#Order###########None###########Other#(please#identify):#___________________________________________#
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########Deposit#Account##Deposit#Account#Number:#_______________________##Deposit#Account#Name:#______________________#
#########For#the#above‐identified#deposit#account,#the#Director#is#hereby#authorized#to#(check#all#that#apply):#
#####################Charge#fee(s)#indicated#below##########################################################Charge#fee(s)#indicated#below,#except#for#the#filing#fee#
#
#####################Charge#any#additional#fee(s)#or#underpayment#of#fee(s)#############Credit#any#overpayment#of#fee(s)#
#####################under#37#CFR#1.16#and#1.17#
WARNING:##Information#on#this#form#may#become#public.#Credit#card#information#should#not#be#included#on#this#form.#Provide#credit#card# information#and#authorization#on#PTO‐2038.#
FEE#CALCULATION# |
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1.##BASIC#FILING,#SEARCH,#AND#EXAMINATION#FEES#(U#=#undiscounted#fee;#S#=#small#entity#fee;#M#=#micro#entity#fee)# |
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FILING#FEES# |
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SEARCH#FEES |
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EXAMINATION#FEES# |
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Application#Type# |
U#($)# |
S#($)# |
M#($)# |
U#($) |
S#($) |
M#($) |
U#($) |
S#($)# |
M#($)# |
Fees#Paid#($) |
Utility# |
280# |
140*# |
70# |
600 |
300 |
150 |
720 |
360# |
180# |
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Design# |
180# |
90# |
45# |
120 |
60 |
30 |
460 |
230# |
115# |
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Plant# |
180# |
90# |
45# |
380 |
190 |
95 |
580 |
290# |
145# |
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Reissue# |
280# |
140# |
70# |
600 |
300 |
150 |
2,160 |
1,080# |
540# |
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Provisional# |
260# |
130# |
65# |
0 |
0 |
0 |
0 |
0# |
0# |
# |
*#The#$140#small#entity#status#filing#fee#for#a#utility#application#is#further#reduced#to#$70#for#a#small#entity#status#applicant#who#files#the#application#via#EFS‐Web.# 2.##EXCESS#CLAIM#FEES#
Fee#Description# |
# |
# |
Undiscounted#Fee#($) |
Small#Entity#Fee#($)# |
Micro Entity#Fee#($) |
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Each#claim#over#20#(including#Reissues)# |
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80 |
40# |
20 |
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Each#independent#claim#over#3#(including#Reissues)# |
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420 |
210# |
105 |
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Multiple#dependent#claims# |
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780 |
390# |
195 |
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Total#Claims# |
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Extra#Claims |
Fee#($) |
Fee#Paid#($) |
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__________ |
#‐20#or#HP#=# |
__________#x |
__________#######= |
__________ |
Multiple#Dependent#Claims |
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HP#=#highest#number#of#total#claims#paid#for,#if#greater#than#20. |
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Fee#($)# |
Fee#Paid#($) |
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Indep.#Claims# |
# |
Extra#Claims |
Fee#($) |
Fee#Paid#($) |
__________# |
__________ |
__________ |
#‐3#or#HP#=# |
__________#x |
__________#######= |
__________ |
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HP#=#highest#number#of#independent#claims#paid#for,#if#greater#than#3. |
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3.##APPLICATION#SIZE#FEE#
If#the#specification#and#drawings#exceed#100#sheets#of#paper#(excluding#electronically#filed#sequence#or#computer#listings#under#37#CFR#1.52(e)),# the#application#size#fee#due#is#$400#($200#for#small#entity)#($100#for#micro#entity)#for#each#additional#50#sheets#or#fraction#thereof.#See#35#U.S.C.# 41(a)(1)(G)#and#37#CFR#1.16(s).#
Total#Sheets# |
Extra#Sheets# |
Number#of#each#additional#50#or#fraction#thereof |
Fee#($)# |
Fee#Paid#($) |
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__________#‐ 100#=# |
__________#/#50#=# |
__________#(round#up to#a#whole#number)##########x |
__________####=# |
__________ |
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4.##OTHER#FEE(S)# |
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Fees#Paid#($)# |
Non‐English#specification,#$130#fee#(no#small#or#micro#entity#discount)# |
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__________# |
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Non‐electronic#filing#fee#under#37#CFR#1.16(t)#for#a#utility#application,#$400#fee#($200#small#or#micro#entity)# |
__________# |
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Other#(e.g.,#late#filing#surcharge):##_______________________________________________________________________# |
__________# |
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SUBMITTED#BY# |
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Signature# |
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Registration#No. |
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Telephone# |
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(Attorney/Agent)# |
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Name#(Print/Type)# |
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Date# |
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This#collection#of#information#is#required#by#37#CFR#1.136.#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#30#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.#
If#you#need#assistance#in#completing#the#form,#call#1‐800‐PTO‐9199#and#select#option#2.#
Privacy Act Statement
The Privacy Act of 1974 (P.L.
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 Information 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.
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