Application For A Community Trade Mark Page 2
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1
2APPLICATION FOR A COMMUNITY TRADE MARK
Representative
ID number
Name
Tel, fax, e-mail
Address
Street and number
City and postal code
Country
Postal address
(if different)
Type of representative
legal practitioner
professional representative
association of representatives
employee
Priority claimed
The applicant claims the priority of the earlier
Certificate(s)
attached
to follow
filing(s) mentioned below
Country of first filing
Number
Filing date*
/
/
Continuation sheet(s)
Seniority claimed
The applicant claims the seniority of the earlier
Certificate(s)
attached
to follow
registration(s) mentioned below
Member State
Nature (national / international)
Number
Filing date*
/
/
/
/
/
/
/
/
/
/
/
/
Continuation sheet(s)
Translation of
Transformation under Madrid Protocol
IR number
List of goods/ services
attached
/
/
Date of cancellation of the IR
Colours
attached
Date of the IR
/
/
Description of the mark
attached
Disclaimer
attached
Date of priority of the IR
/
/
Payment of fees
Current account with OHIM
Basic CTM fee
€
Account No.
Classes exceeding three
€
Do not use my current account with OHIM
Basic application fee and, if applicable, the fee for the
Fee for national search reports
€
national search reports
Total fees
€
to be withdrawn from current account of applicant /
representative with OHIM
Transfer to account of OHIM
immediately
Banco Bilbao Vizcaya Argentaria
one month after the filing date
La Caixa
together with the class fee
/
/
Date of transfer (DD/MM/YYYY)
page number
* DD/MM/YYYY
RESET FORM
of
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Parent category: Business