Global Format; form 1957 (Rev 8/2009) |
OMB No. 0651-0050 (Exp. 10/31/2017) |
Input Field |
Entered |
---|---|
SERIAL NUMBER | 76233112 |
REGISTRATION NUMBER | |
FORM TEXT | |
The applicant submits an authorization of Credit Card Payment Form. The card holder, Kathryn P. Sherer was the officer who signed the Statement of Use. We are attaching the original signed Credit Card Payment Form. The Office is hereby authorized to charge the filing fee for the statement of use to the attached credit card account. |
|
ATTACHMENT(S) | |
ORIGINAL PDF FILE | K Sherer Credit Card Authorization Form_20101134842898.pdf |
CONVERTED PDF FILE(S) (1 page) |
\\TICRS\EXPORT11\IMAGEOUT11\762\331\76233112\xml9\ROA0002.jpg |
PAYMENT SECTION | |
NUMBER OF CLASSES | 1 |
FEE PER CLASS | 100 |
TOTAL FEES DUE | 100 |
SIGNATURE SECTION | |
DECLARATION SIGNATURE | /Kathryn P. Sherer/ |
SIGNATORY'S NAME | Kathryn P. Sherer |
SIGNATORY'S POSITION | Assistant Secretary |
DATE SIGNED | 12/03/2010 |
SUBMISSION SIGNATURE | /Kathryn P. Sherer/ |
SIGNATORY'S NAME | Kathryn P. Sherer |
SIGNATORY'S POSITION | Assistant Secretary |
DATE SIGNED | 12/03/2010 |
AUTHORIZED SIGNATORY | YES |
FILING INFORMATION SECTION | |
TEAS STAMP | USPTO/ROA-XX.XXX.XXX.XX-2 0101206094028784026-76233 112-20101203160254278343- CC-9338-20101203160254278 343 |
Global Format; form 1957 (Rev 8/2009) |
OMB No. 0651-0050 (Exp. 10/31/2017) |
The applicant submits an authorization of Credit Card Payment Form. The card holder, Kathryn P. Sherer was the officer who signed the Statement of Use. We are attaching the original signed Credit Card Payment Form. The Office is hereby authorized to charge the filing fee for the statement of use to the attached credit card account.
FORM FILE NAME(S)