(1) Title of the Mark____________________________
________________________________________________ (If a verbal TM, indicate this in upper letters above). If a pictorial TM or a verbal plus a Pictorial TM, affix an illustration of the TM within this space |
Application No.
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The Director General
Intellectual Property Office Makati City S I R : The undersigned requests that the above- mentioned mark be registered according to R. A. 8293. |
(2) Name and address of Applicant/s | (3) Citizenship or State of Incorporation | |
(4) Address of real and effective business establishment | ||
(5) Name of representative, if any and address | ||
(6) Goods or Services | (7) Class/es, if known | |
(8) Manner of using the Mark | (9)
Based on Foreign Reg.
a) Reg. No. ___________________________ b) Date: _____________________________ |
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(10)
Claim of Priority, if any.
(a) State where earlier (b) Name of Office where (c) Date of Application (d) Application No., If available application was filed application was filed ___________________ ___________________ ______________________ _____________________ ___________________ ___________________ ______________________ _____________________ ___________________ ___________________ ______________________ _____________________ ___________________ ___________________ ______________________ _____________________ |
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(11) Translation or Transliteration, if any. | ||
(12) Disclaimer, if any. | ||
(13) Specific Description of Mark, Design, Device or Logo | ||
(14) Is the Mark Three-Dimensional | (15) Claim of color/s, if any. |
(16)
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(17) Checklist of Annex/es
Number of Pages
[ ] Additional list of goods ______________ [ ] Claim of Priority ______________ [ ] Home of Applications ______________ [ ] Disclaimer ______________ [ ] Claim of Color/s ______________ [ ] Translation/Transliteration ______________ |
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