REPUBLIC OF ZAMBIA
PATENTS FORM NO. 2
Sections 8, 11, 12
Regulation 3 (2)
THE PATENTS ACT
Fee units: 24
CONVENTION APPLICATION FOR A PATENT
(This is a comprehensive form and points inappropriate to a
particular application should be deleted)
I/We (1)
(1) State
full name
and address
of
applicant(s)
being a national/nationals of
(2) Delete
do hereby declare that I am/we are the owner(s) of an invention in respect of the Republic of if not
Zambia (2) by having invented it/by having acquired it by assignment, which invention
applicable
(3) Here
is entitled (3)
insert title
of
invention
(4) Here
and which invention is described in the accompanying complete specification, and that (2) insert
name(s) of
I am/we are the assignee(s)/legal representative(s) of (4)
inventor(s)
who claim(s) to be the inventor(s) thereof; that an application or applications for
protection for the invention or inventions has or have been made in the following country or
countries and on the following effective date or dates, namely:
in (5) .............................................................. on (6) ............................................................ (5) Here
insert the
numbered (7) ...................................................................
name of
in (5) on (6) ............................................................
the