6.
riority declaration3
P
(a) Country4 _____________________________________________
(b) Filing date ___________________________________________
(c) Application No. _______________________________________
(d) IPC symbol __________________________________________
7.
Check list—
(a) This application contains the following—
(i) request _______________________ sheet(s)
(ii) description ____________________ sheets
(iii) claim(s) ______________________ sheets
(iv) abstract ______________________ sheets
(v) drawings _____________________ sheets
(b)
This form is accompanied by the items checked below—
(i) _____ power of attorney
(ii) _____ statement specifying the basis of applicant’s right to
the patent
(iii) _____ statement that certain disclosures be disregarded
(iv) _____ priority documents (certified)
(v) _____ English translation of earlier applications on which
priority declaration is based
(vi) _____ other documents (specify)
Drawing No. _____________ is suggested to accompany the
abstract for publication.
8.
3
Signed __________________________________________________
Date ____________________________________________________
If priority of more than one earlier application is claimed, the data should be indicated on
an additional sheet of paper.
4
If earlier application is a regional or international application, indicate here the office in
which and the countries for which it was filed.