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Supplementary Search Request PCT-IB-375 - Official Federal Forms

Supplementary Search Request Form. This is a national form and can be used in International Bureau PCT US Patent Office .
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The supplementary search request must be filed directly with the International Bureau. The full name or two-letter code of the Authority specified for supplementary search must be indicated by the applicant below: AUTHORITY/ PCT SUPPLEMENTARY SEARCH REQUEST Under Rule 45bis.1, the undersigned requests that a supplementary international search be carried out in respect of the international application specified below: For International Bureau use only Identification of Authority Box No. I Date of receipt of Request Applicant's or agent's file reference (Earliest) Priority date (day/month/year) IDENTIFICATION OF THE INTERNATIONAL APPLICATION International filing date (day/month/year) International application No. Title of invention Box No. II APPLICANT Telephone No. The address must include postal code and name of country.) Name and address: (Family name followed by given name; for a legal entity, full official designation. Facsimile No. Applicant's registration No. with the Office E-mail authorization: Marking one of the check-boxes below authorizes the International Bureau and the Authority specified for supplementary search to use the e-mail address indicated in this Box to send notifications issued in respect of this international application if those offices are willing to do so. exclusively in electronic form (no paper notifications will be sent). as advance copies followed by paper notifications; or E-mail address: ___________________________________________________________________________ State (that is, country) of nationality: State (that is, country) of residence: Box No. III AGENT OR COMMON REPRESENTATIVE; OR ADDRESS FOR CORRESPONDENCE agent common representative The following person is and has been appointed earlier and represents the applicant(s) also for the supplementary international search. is hereby appointed and any earlier appointment of (an) agent(s)/common representative is hereby revoked. is hereby appointed, specifically for the procedure before this Authority specified for supplementary search, in addition to the agent(s)/common representative appointed earlier. Telephone No. Name and address: (Family name followed by given name; for a legal entity, full official designation. The address must include postal code and name of country.) Facsimile No. Agent's registration No. with the Office E-mail authorization: Marking one of the check-boxes below authorizes the International Bureau and the Authority specified for supplementary search to use the e-mail address indicated in this Box to send notifications issued in respect of this international application if those offices are willing to do so. as advance copies followed by paper notifications; or exclusively in electronic form (no paper notifications will be sent). E-mail address: ___________________________________________________________________________ Form PCT/IB/375 (first sheet) (January 2015) See Notes to the supplementary search request American LegalNet, Inc. www.FormsWorkFlow.com International application No. Sheet No. . . . Continuation of Box No. III ADDRESS FOR CORRESPONDENCE Address for correspondence: Mark this check-box where no agent or common representative is/has been appointed and the space above is used instead to indicate a special address to which correspondence should be sent. Box No. IV BASIS FOR SUPPLEMENTARY INTERNATIONAL SEARCH Language for the purposes of supplementary international search: ________________________________________________ which is the language in which the international application was filed which is the language of translation furnished for the purposes of international search which is the language of translation furnished for the purposes of international publication which is the language of the translation to be furnished for the purposes of supplementary international search Following the finding by the International Searching Authority that the international application does not comply with the requirements of unity of invention, the applicant wishes to limit the supplementary international search to one of the inventions as identified by the International Searching Authority other than the main invention referred to in Article 17(3)(a). The numbers of the claims relating to this invention are: Box No. V CHECK LIST For International Bureau use only The supplementary search request is accompanied by the item(s) marked below: 1. 2. 3. 4. 5. 6. 7. translation of the international application for the purposes of the supplementary international search (Rule 45bis.1(c)(i)) fee calculation sheet original separate power of attorney original general power of attorney copy of general power of attorney; reference number, if any: sequence listing in the form of an Annex C/ST.25 text file (Rule 45bis.1(c)(ii)) statement confirming that the copy of the sequence listing in the form of an Annex C/ST.25 text file (see above) is identical to the sequence listing forming part of the international application as filed other (specify): received not received 8. Box No. VI SIGNATURE OF APPLICANT, AGENT OR COMMON REPRESENTATIVE Next to each signature, indicate the name of the person signing and the capacity in which the person signs (if such capacity is not obvious from reading this request). For International Bureau use only 1. Date of actual receipt of REQUEST: 2. 3. 4. The date of receipt is AFTER the expiration of 19 months from the priority date and items 3 and 4, below, do not apply. The date of receipt of the request is WITHIN the time limit of 19 months from the priority date as extended by virtue of Rule 80.5. Although the date of receipt of the request is after the expiration of 19 months from the priority date, the delay in arrival is EXCUSED pursuant to Rule 82. See Notes to the supplementary search request American LegalNet, Inc. www.FormsWorkFlow.com Form PCT/IB/375 (last sheet) (January 2015) NOTES TO THE SUPPLEMENTARY SEARCH REQUEST FORM (PCT/IB/375) These notes are intended to facilitate the filing of the supplementary search request form and to give some information concerning the supplementary international search. For more detailed information, see the PCT Applicant's Guide, a WIPO publication, which is available, together with other PCT related documents, on WIPO's website: www.wipo.int/pct/en/. The Notes are based on the requirements of the PCT, the Regulations and the Administrative Instructions under the PCT. In case of any discrepancy between these Notes
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