PTO/SB/16 (10-20) Approved for use through 11/30/2020. 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 PROVISIONAL APPLICATION FOR PATENT COVER SHEET – Page 1 of 2 This is a request for filing a PROVISIONAL APPLICATION FOR PATENT under 37 CFR 1.53(c). Priority Mail Express® Label No. ______________________________________________________________ INVENTOR(S) Given Name (first and middle [if any]) Family Name or Surname Residence (City and either State or Foreign Country)
Additional inventors are being named on the __________________ separately numbered sheets attached hereto. TITLE
Additional inventors are being named on the __________________ separately numbered sheets attached hereto. TITLE