Patent Form - Brela Page 4
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4A.
This application contained
B.
This Form, as filed, is accompanied
the following
the items ticked below
1.
request………………..shete(s)
separate signed power of
2.
description……………sheet(s)
attorney statement justi-
3.
claim(s)………………sheet(s)
fying the applicant’s right
4.
abstract ………………sheet(s)
statement that certain dis-
5.
drawing(s)………….. sheet(s)
closure be disregarded.
Total
sheet(s)
Priority documents (certi-
fied copy or earlier appli-
cation(s)
English translation of
earlier application(s) on
which priority declara-
tion is based.
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application fee
C. figure number ……………….of the
company (if any) is suggested to
accompany the abstract for publi-
other documents(specify)
cation.
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X.
SIGNATURE(S)…………………………………DATE……………………..
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• type name(s) under signature
TO BE FILLED IN BY THE REGISTRAR
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1. Date of receipt of corrections or later filled documents completing the application:
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2. Date fees received.
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