Trademark Application Form - Dpt Law

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Office Use Only
Trademark Application Form
Republic Act No. 8293
1. Applicant
Name
Country of Residence or Incorporation
Natural
Juridical
Complete Address
Facsimile:
Telephone:
Email:
Name/s of other applicant/s (if any)
2. Resident Agent or Authorized Representative
Agent
Agent Code
Address in the Philippines
Name and Position of Company’s Authorized Representative (if applicant is not represented by agent)
Address in the Philippines
3. Address for service of correspondence in the Philippines
Please check one:
Applicant’s address
Agent’s address
Authorized Representative’s address
Facsimile:
Telephone:
Email:
4. The Mark
(Place a copy of the mark in the box. The mark should be clear enough to be reproduced and digitized.
Title of Mark
If the mark consists of image/s or words and image/s, give a complete and concise
description of the mark. (Use additional sheet/s if necessary.)
TM001_0109 – Page 1 of 2

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