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Application For International Registration Governed Exclusively By The Madrid Protocol MM2(E) - Official Federal Forms

Application For International Registration Governed Exclusively By The Madrid Protocol Form. This is a national form and can be used in Madrid System World Intellectual Property Organization .
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MM2(E) MADRID AGREEMENT AND PROTOCOL CONCERNING THE INTERNATIONAL REGISTRATION OF MARKS APPLICATION FOR INTERNATIONAL REGISTRATION GOVERNED EXCLUSIVELY BY THE MADRID PROTOCOL (Rule 9 of the Common Regulations) IMPORTANT 1. The present MM2 form is to be used where the international application is governed exclusively by the Madrid Protocol. This will be the case: ­ where the Office of origin (see items 1 and 3) is the Office of a Contracting Party which is bound by the Madrid Protocol only, or ­ where the Office of origin is the Office of a Contracting Party which is bound by both the Madrid Agreement and the Protocol, and where all the designated Contracting Parties are party to the Protocol, irrespective of whether or not they are also party to the Agreement. 2. If the international application is governed exclusively by the Madrid Agreement, the form to be used is form MM1. If it is governed by both the Madrid Agreement and the Protocol, the form to be used is form MM3. 3. This form must be sent to the Office of origin. It must not be sent directly to the International Bureau. World Intellectual Property Organization 34, chemin des Colombettes 1211 Geneva 20, Switzerland Tel. (Switchboard): +41 (0)22 338 9111 Fax (Madrid Registry): +41 (0)22 740 1429 e-mail: intreg.mail@wipo.int ­ Internet: http://www.wipo.int MM2(E) ­ February 2013 American LegalNet, Inc. www.FormsWorkFlow.com MM2(E) APPLICATION FOR INTERNATIONAL REGISTRATION GOVERNED EXCLUSIVELY BY THE MADRID PROTOCOL For use by the applicant For use by the applicant/Office This international application includes the following number of: ­ continuation sheet(s): Applicant's reference: ­ MM17 form(s): Office's reference: 1 CONTRACTING PARTY WHOSE OFFICE IS THE OFFICE OF ORIGIN 2 APPLICANT (a) Name: (b) Address: (c) Address for correspondence: (d) Telephone : Fax: E-mail address: Please check this box if you wish to receive electronic communication. By checking this box: (i) any further correspondence from the International Bureau related to this international application and its resulting international registration will be sent only electronically; likewise, (ii) any further correspondence from the International Bureau related to other international applications or international registrations for which the same e-mail address has been provided will be sent only electronically. Please note that, for the purpose of electronic communication, there can be only one e-mail address recorded per each international application. (e) Preferred language for correspondence: English French Spanish (f) Other indications (as may be required by certain designated Contracting Parties; for example, if the United States of America is designated, it is necessary to include these indications): (i) if the applicant is a natural person, nationality of applicant: (ii) if the applicant is a legal entity: ­ legal nature of the legal entity: ­ State and, where applicable, territorial unit within that State, under the law of which the legal entity is organized: MM2(E) ­ February 2013 American LegalNet, Inc. www.FormsWorkFlow.com MM2(E), page 2 3 ENTITLEMENT TO FILE (a) Check the appropriate box: (i) where the Contracting Party mentioned in item 1 is a State, the applicant is a national of that State; or (ii) where the Contracting Party mentioned in item 1 is an organization, the name of the State of which the applicant is a ; or national: (iii) the applicant is domiciled in the territory of the Contracting Party mentioned in item 1; or (iv) the applicant has a real and effective industrial or commercial establishment in the territory of the Contracting Party mentioned in item 1. (b) Where the address of the applicant, given in item 2(b), is not in the territory of the Contracting Party mentioned in item 1, indicate in the space provided below: (i) (ii) if the box in paragraph (a)(iii) of the present item has been checked, the domicile of the applicant in the territory of that Contracting Party, or, if the box in paragraph (a)(iv) of the present item has been checked, the address of the applicant's industrial or commercial establishment in the territory of that Contracting Party. 4 APPOINTMENT OF A REPRESENTATIVE (if any) Name: Address: Telephone: Fax: E-mail address: Please check this box if you wish to receive electronic communication. By checking this box: (i) any further correspondence from the International Bureau related to this international application and its resulting international registration will be sent only electronically; likewise, (ii) any further correspondence from the International Bureau related to other international applications or international registrations for which the same e-mail address has been provided will be sent only electronically. Please note that, for the purpose of electronic communication, there can be only one e-mail address recorded per each international application. 5 BASIC APPLICATION OR BASIC REGISTRATION Basic application number: Date of the basic application: (dd/mm/yyyy) Basic registration number: Date of the basic registration: (dd/mm/yyyy) 6 PRIORITY CLAIMED The applicant claims the priority of the earlier filing mentioned below: Office of earlier filing: Number of earlier filing (if available): Date of earlier filing: (dd/mm/yyyy) If the earlier filing does not relate to all the goods and services listed in item 10 of this form, indicate in the space provided below the goods and services to which it does relate: If several priorities are claimed, check box and use a continuation sheet giving the above required information for each priority claimed. MM2(E) ­ February 2013 American LegalNet, Inc. www.FormsWorkFlow.com MM2(E), page 3 7 THE MARK (a) Place the reproduction of the mark, as it appears in the basic application or basic registration, in the square below. (b) Where the reproduction in item (a) is in black and white and color is claimed in item 8, place a color reproduction of the mark in the square below. (c) The applicant declares that he wishes the mark to be considered as a mark in standard characters. (d) The mark consists of a color or a combination of colors as such. Where the Office of origin has addressed this form by facsimile, the present space must be completed before addressing the original of this page to the International Bureau. Number of basic registration or Office reference as shown on the first page of this form: Signature by the Office of origin: 8 COLOR(S) CLAIMED (a) The a
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