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If you are submitting material that is filed by or for a former employee, please reference your original employee number. OMB control number (C:): 800001, R: 11/15/2009. Please describe the activity for which you are completing this form. For all items, please include the following: Date of activity. Nature of the activity Date filed (optional; in some cases, this is also the final date) For activities which are not yet processed, please describe the activity. For example, report the date of the review or issuance or the date of the review of a patent application. The activity should be clear and concise. Please provide the name of the person, and the address, location, and telephone number where information can be sent. If you are not sure how to write this information, contact the OMB Help Desk. If the activity is an application or patent or a review or issuance or review of a patent application, please include the name of the person who conducted the activity. This is the applicant, or the person in whom the applicant has vested authority, the agency, or the patent examiner or the Department or sub-agency. This information must be provided in order to facilitate the completion of your report. For example, if it is an examination of the patent ability of a new method of making a compound, please write the name of the examiner involved in the activity and where the activity occurred. If the activity was a registration or a patent, please describe the activity as well. For applications and patents with a period beginning before October 7, 1995 (the date the system transitioned from manual publication to automated publication), please include at the beginning of the item the number of your year of birth and a code indicating what type of document you are creating (as shown in the upper right corner). Do NOT submit this information for those documents which are in electronic form. If you do not know what type of document you are submitting, contact the OMB Help Desk. For records created prior to October 7, 1995, please include the following information: the month and year (if applicable), the patent number, the country in which you worked, the United States, the region where you worked, the name of the United States in which the work is done, your employee number, and Your title, if different from the name shown in the title area (for example, “Assistant to the Secretary/Legal Fellow”).