The above-named person/s request(s) the Controller to amend the above application for
the grant of a Patent in accordance with section 15(2) of the Patents, Industrial Designs
and Trademarks Act 2002.
______________________________________________________________________________
_____________________
7.

AGENT (if you have one)
Name

of

Agent:………………………………………………………………………………………………
………………….….
"Address for service" in Mauritius to which all correspondence should be sent
………………………………………………………………………………………………
………………………………………..
………………………………………………………………………………………………
…………………………………………
______________________________________________________________________________
_____________________8.
Yes

ADDITIONAL INFORMATION accompanies this Form:

No

______________________________________________________________________________
_____________________
9.

Name and telephone number of person to contact in Mauritius
Name:………………………………………………………………………………………

………………………………………..
Telephone number: ……………………………………
______________________________________________________________________________
_____________________

10.

……………………………..
SIGNATURE…………………………………
(Date)

_______
*Delete whichever is not applicable

*(Applic

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