2.

PERSON(S) MAKING REQUEST:
Name:
………………………………………………………………………………………………

……………………….

………………………………………………………………………………………………
……………………….
Address:
………………………………………………………………………………………………
………………………

…��…………………………………………………………………………………………
………………………
Telephone Number

Fax Number

(if any)

(if any)

……….……………

………………….
..………………….

______________________________________________________________________________
_____________________
3.

What kind of amendment or correction do you want to make?
-

-

Clerical error

-

-

Obvious mistake

-

-

Amendment of specification

______________________________________________________________________
_____________________________4.

What is the amendment or correction you

want to make?
(continue on a separate sheet of paper if necessary)

5.

What is the reason for the request?
(continue on a separate sheet of paper if necessary)

______________________________________________________________________________
_____________________6.

REQUEST:

E-mail
(if any)

Select target paragraph3