Please submit this Form (in duplicate) together with the fee as specified in the First Schedule of
the Patents, Industrial Designs and Trademarks Act 2002
Applicant’s or Agent’s file reference:……………………………………………
1.
Patent No:……………………………………………………………..…………Date of
Grant…………………………………
2.
OWNER(S):
Name:…………………………………………………………………………………
………………………………………..
Address…………………………………………………………………………………
………………………………………
………………………………………………………………………………
…………………………………………
________________________________________________________________________
_____________________________________
3.
3.
SUPPORTING DOCUMENTS:
Documents are enclosed
Documents
will
be
submitted
by………………………………………………………………………………………….. (date)
______________________________________________________________________________
_____________________
4.
REQUEST:
The owner(s) request(s) the Controller to amend, as attached, the above-identified patent
in accordance with section 20(4) of the Patents, Industrial Designs and Trademarks Act
2002.
______________________________________________________________________________
_____________________
5.
REASON FOR REQUEST:
(a)
(a)
Correction of clerical error