Maintenance Fee Reminder
	
Next fee due: ____/____ /____
	yr	mo	date
(Write year in pencil and change after each payment)

Patent Nr.: ________________________________ Issued: _______________________
Application Serial Nr.: _______________________	Filed: ________________________	
Title: __________________________________________________________________
Patentee(s) (Inventor[s]/Applicant[s]): ________________________________________
Assignee(s) (if any): ______________________________________________________	
Expires __________________________________ (if all three maintenance fees are paid).1
[  ]	Small entity status was filed in application or patent.
(If not, large entity fees2 must be paid.)

Maintenance Fee Number	Fee Due	Sent Form 
& Check4	Amount	Received Receipt Statement	
	From: 	To:				
I. Due 3.0 - 3.5 YAI3	       /   /  	       /   /  	       /   /  	 $	       /   /  	
II. Due 7.0 - 7.5 YAI	       /   /  	       /   /  	       /   /  	 $	       /   /  	
III. Due 11.0 - 11.5 YAI	       /   /  	       /   /  	       /   /  	 $	       /   /  	

Notes: __________________________________________________________________ ________________________________________________________________________
	
1 For applications filed after 1995 June 7, expiration is 20 years from filing date of application, or from any earlier domestic nonprovisional (regular) application from which it claims priority, plus any adjustment (extension) granted by the PTO.
2 Please check all fee amounts before paying, since PTO fees change often. 
3 YAI = Years After Issue date.
4 Send or make Internet payment at least a month before due date to allow time to take corrective action before entering grace (penalty) period in case PTO does not accept payment.