321
Form No. I (cont'd)
will be furnished upon request, by the Registrar, as prescribed
by Regulation 19(5).
D
The certified English translation of the earlier application
accompanies this Form
D
D
VIII.
will be furnished upon request, as prescribed by Regulation 19(7).
SUPPLEMENTAL BOX*
IX. CHECK LIST
A.
This appiication contains the
following:
request................. sheet(s)
description............ sheet(s)
3. claim(s)................ sheet(s)
4. abstract................ sheet(s)
5. drawing(s) .............. sheet(s)
1.
2.
Total
sheets
C. Figure number ... of the drawings
(if any) is suggested to accompany the
abstract for publication
B.
This Form, as filed, is
accompanied by the items ticked
below:
separate signed power of
attorney
statement justifying the
applicant's right
statement that certain
disclosures· b~ disregarded
priority
document(s)
(certified copy of earlier
application(s»
certified English
translation of earlier
application(s) on which
priority declaration is
based
application fee
D
D
D
D
D
D
D
other document(s)
(specify)
X. SIGNA TURE(S) **
(Applicant(s)/ Agent)
(Date)