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Form D5
Late lodging of documents
(Regulation 23)
(Lodge in duplicate)
Date of lodgement:

Application No.:

Full names) of applicant(s):

The following documents not accompanying the application as lodged or required by the
Registrar are hereby submitted:
1.

Representations:

Sheets:

Copies:

2.

Publication particulars on Form D8 (in duplicate)

3.

Representation for publication

4.

Certified priority document(s)

5.

Translation of priority document(s)

6.

Assignment of priority rights

7.

Declaration and power of attorney on Form D3

8.

Request for classification on Form D9 (in duplicate)

Date:
______________________________
APPLICANT/APPLICANT'S AGENT
Address for service:

FOR OFFICIAL USE ONLY
Late lodging of documents is acknowledged

Official date stamp
……………………

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