______________________________________________________________________________
_____________________4.

REPRESENTATIONS OF THE INDUSTRIAL DESIGN;

SPECIMEN
This Form is accompanied by
four graphic representations

four drawings or tracings

a specimen of the industrial design
______________________________________________________________________________
_____________________
5.

PRODUCTS
The list of products which constitute the Industrial Design or in relation to which the
industrial design(s) is/are to be used.
Class Number

List of

Products**
…………………
……………………………………………………….
………………..
……………………………………………………….
………………..
……………………………………………………….

______________________________________________________________________________
_____________________
6.

DISCLOSURES TO BE DISREGARDED FOR PRIOR ART PURPOSES:
(a)

Disclosure was due to acts of applicant or his predecessor in title
Date of disclosure………………………………………

(b)

Disclosure was due to abuse or rights of applicant or his predecessor in title
Date of disclosure………………………………………

A statement specifying full particulars of disclosure accompanies this FORM:
Yes

If 'No', the statement should be filed within one month from the filing of the application.

No

Select target paragraph3