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Request For The Recording Of A Change In Name And-Or Address Of The Representative MM10(E) - Official Federal Forms
| Request For The Recording Of A Change In Name And-Or Address Of The Representative Form. This is a national form and can be used in Madrid System World Intellectual Property Organization . |
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MM10(E) MADRID AGREEMENT AND PROTOCOL CONCERNING THE INTERNATIONAL REGISTRATION OF MARKS REQUEST FOR THE RECORDING OF A CHANGE IN NAME AND/OR ADDRESS OF THE REPRESENTATIVE (Rule 25 of the Common Regulations) IMPORTANT This form is to be used only to request the recording of a change in the name or address of the recorded representative and not to appoint a new representative. 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 MM10(E) January 2013 American LegalNet, Inc. www.FormsWorkFlow.com MM10(E) REQUEST FOR THE RECORDING OF A CHANGE IN NAME AND/OR ADDRESS OF THE REPRESENTATIVE For use by the representative For use by the representative/Office This request contains the following number of continuation sheets: .................................... Representative's reference: ............................................................... Office's reference: ............................................................................ 1 INTERNATIONAL REGISTRATION NUMBER(S) (this form may be used for several international registrations of the same representative) 2 REPRESENTATIVE (as recorded in the International Register) Name: Address: 3 CHANGE IN NAME AND/OR ADDRESS OF THE REPRESENTATIVE (indicate the change(s)) New name: New address: New telephone: New fax: New 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. MM10(E) January 2013 American LegalNet, Inc. www.FormsWorkFlow.com MM10(E), page 2 4 SIGNATURE BY THE HOLDER OR HIS REPRESENTATIVE Holder (as recorded in the International Register) Representative of the holder (as recorded in the International Register) Name: Name: Signature: Signature: 5 OFFICE PRESENTING THE REQUEST (if applicable) Name of the Office Signature and/or stamp of the Office MM10(E) January 2013 American LegalNet, Inc. www.FormsWorkFlow.com CONTINUATION SHEET No: .......... of .......... MM10(E) January 2013 American LegalNet, Inc. www.FormsWorkFlow.com
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