Form PTO/SB/22 Petition for Extension of Time under 37 CFR 1.136(a)

PTO/SB/22 (10-12)
Approved for use through 1/31/2013. OMB 0651-0031
U.S. Patent and Trademark Office; U.S. DEPARTMENT OF COMMERCE
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Docket Number (Optional)

PETITION FOR EXTENSION OF TIME UNDER 37 CFR 1.136(a)
Application Number

Filed

For
Art Unit

Examiner

This is a request under the provisions of 37 CFR 1.136(a) to extend the period for filing a reply in the above-identified application.
The requested extension and fee are as follows (check time period desired and enter the appropriate fee below):
Fee

Small Entity Fee

One month (37 CFR 1.17(a)(1))

$150

$75

$_________________

Two months (37 CFR 1.17(a)(2))

$570

$285

$_________________

Three months (37 CFR 1.17(a)(3))

$1,290

$645

$_________________

Four months (37 CFR 1.17(a)(4))

$2,010

$1,005

$_________________

Five months (37 CFR 1.17(a)(5))

$2,730

$1,365

$_________________

Applicant claims small entity status. See 37 CFR 1.27.
A check in the amount of the fee is enclosed.
Payment by credit card. Form PTO-2038 is attached.
The Director has already been authorized to charge fees in this application to a Deposit Account.
The Director is hereby authorized to charge any fees which may be required, or credit any overpayment, to
Deposit Account Number ____________________________.
Payment made via EFS-Web.
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.
I am the
applicant/inventor.
assignee of record of the entire interest. See 37 CFR 3.71. 37 CFR 3.73(b) statement is enclosed (Form PTO/SB/96).
attorney or agent of record. Registration number _____________________________.
attorney or agent acting under 37 CFR 1.34. Registration number _____________________________.

___________________________________________________
Signature

___________________________________________________
Date

___________________________________________________
Typed or printed name

___________________________________________________
Telephone Number

NOTE: This form must be signed in accordance with 37 CFR 1.33. See 37 CFR 1.4 for signature requirements and certifications. Submit
multiple forms if more than one signature is required, see below*.
* Total of ________________ forms are submitted.
This collection of information is required by 37 CFR 1.136(a). 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 1.11 and 1.14. This collection is estimated to take 6 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: Mail Stop PCT, Commissioner for Patents, P.O. Box 1450, Alexandria, VA 22313-1450.

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