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Form P4
(To be lodged in duplicate)
REPUBLIC OF SOUTH AFRICA
PATENTS ACT, 1978
APPLICATION OR REQUEST TO THE REGISTRAR
(Regulation 39)
Fees payable in terms of
Schedule I of the Regulations
Official date stamp
Patent/Application No.
21
01
In the name of:
In terms of section ………………………………………. of the Act and/or regulation…………….
of the Patent Regulations, the applicant hereby requests the following:
………………………………………………………………………………………………….
………………………………………………………………………………………………….
………………………………………………………………………………………………….
………………………………………………………………………………………………….
Documents, if any, lodged in support of the request:
………………………………………………………………………………………………….
………………………………………………………………………………………………….
………………………………………………………………………………………………….
………………………………………………………………………………………………….
……………………………………
Signature of applicant or agent
FOR OFFICIAL USE ONLY
The above application or request is hereby allowed/refused.
Reasons for refusal or conditions of allowance, if any:
Official date stamp
……………………….
Registrar or Patents