Form Pct/ib/375 - Supplementary Search Request
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6The supplementary search request must be filed directly with the International Bureau. The full name or two-letter code of the Authority specified
for supplementary search must be indicated by the applicant below:
AUTHORITY/
PCT
SUPPLEMENTARY SEARCH REQUEST
Under Rule 45bis.1, the undersigned requests that a supplementary international search
be carried out in respect of the international application specified below:
For International Bureau use only
Identification of Authority
Date of receipt of Request
Applicant’s or agent’s file reference
Box No. I
IDENTIFICATION OF THE INTERNATIONAL APPLICATION
International application No.
International filing date (day/month/year)
(Earliest) Priority date (day/month/year)
Title of invention
Box No. II
APPLICANT
Telephone No.
Name and address:
(Family name followed by given name; for a legal entity, full official designation.
The address must include postal code and name of country.)
Facsimile No.
Applicant’s registration No. with the Office
E-mail authorization: Marking this check-box authorizes the International Bureau
E-mail address
and the Authority specified for supplementary search to use the e-mail address
indicated in this Box to send, if the Authority so wishes, advance copies of notifications
in respect of this international application. (See also the Notes to Box No. II.)
State (that is, country) of nationality:
State (that is, country) of residence:
Box No. III
AGENT OR COMMON REPRESENTATIVE; OR ADDRESS FOR CORRESPONDENCE
The following person is
agent
common representative
and
has been appointed earlier and represents the applicant(s) also for the supplementary international search.
is hereby appointed and any earlier appointment of (an) agent(s)/common representative is hereby revoked.
is hereby appointed, specifically for the procedure before this Authority specified for supplementary search, in addition to the
agent(s)/common representative appointed earlier.
Telephone No.
(Family name followed by given name; for a legal entity, full official designation.
Name and address:
The address must include postal code and name of country.)
Facsimile No.
Agent’s registration No. with the Office
E-mail authorization: Marking this check-box authorizes the International Bureau
E-mail address
and the Authority specified for supplementary search to use the e-mail address
indicated in this Box to send, if the Authority so wishes, advance copies of notifications
in respect of this international application. (See also the Notes to Box No. II.)
Form PCT/IB/375 (first sheet) (January 2009)
See Notes to the
supplementary search request
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