Madrid agreement and protocol concerning the international registration of marks application for international registration

MADRID AGREEMENT AND PROTOCOL CONCERNING THE

INTERNATIONAL REGISTRATION OF MARKS

APPLICATION FOR INTERNATIONAL REGISTRATION
GOVERNED BY BOTH THE MADRID AGREEMENT AND THE MADRID PROTOCOL
(Rule 9 of the Common Regulations)
IMPORTANT
1. The present MM3 form is to be used where the international application is governed by both the Madrid Agreement and the 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 both the Madrid Agreement and the Protocol, and where the international application designates at least one Contracting State party to the Agreement but not to the Protocol and at least one Contracting Party to the Protocol, irrespective of whether or not that Contracting Party is 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 exclusively by the Madrid Protocol, the form to be used is form MM2.

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, P.O. Box 18,

1211 Geneva 20, Switzerland

Tel.: (41-22) 338 9111

Fax (International Trademark Registry): (41-22) 740 1429

e-mail: intreg.mail@wipo.int – Internet: http://www.wipo.int

This international application includes the following number of:

• 
  continuation sheet(s):
  
• 
  MM17 form(s):
  

Applicant’s reference:

1. 
   Name:
   

2. 
   Address:
   

3. 
   Address for correspondence:
   

4. 
   Telephone : Fax:
   

5. 
   Preferred language for correspondence:  English  French  Spanish
   
6. 
   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):
   

1. 
   if the applicant is a natural person, nationality of applicant:
   
2. 
   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:
  

1. 
   Check the appropriate box:
   

1. 
    the applicant has a real and effective industrial or commercial establishment in the Contracting State mentioned in item 1;
   
2. 
    if there is no such establishment in a Contracting State of the Agreement, the applicant is domiciled in the Contracting State mentioned in item 1;
   
3. 
    if there is no such establishment or domicile in a Contracting State of the Agreement, the applicant is a national of the Contracting State mentioned in item 1.
   

2. 
   Where the address of the applicant, given in item 2(b), is not in the territory of the Contracting State mentioned in item 1, indicate in the space provided below:
   

1. 
   if the box corresponding to paragraph (a)(i) of the present item has been checked, the address of the applicant’s industrial or commercial establishment in that State, or,
   
2. 
   if the box corresponding to paragraph (a)(ii) of the present item has been checked, the domicile of the applicant in that State.
   

Name:

Address:

Telephone: Fax:

E-mail address:

Basic registration number:

Date of the basic registration: (dd/mm/yyyy)

 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.

3. 
    The applicant declares that he wishes the mark to be considered as a mark in standard characters.
   
4. 
    The mark consists of a color or a combination of colors as such
   

Number of basic registration or Office reference as shown on the first page of this form:

Signature by the Office of origin:

1. 
    The applicant claims color as a distinctive feature of the mark.
   

2. 
   Indication, for each color, of the principal parts of the mark that are in that color (as may be required by certain designated Contracting Parties):
   

1. 
   Transliteration of the mark (this information is compulsory where the mark consists of or contains matter in characters other than Latin characters, or numerals other than Arabic or Roman numerals):
   

2. 
   Translation of the mark (as may be required by certain designated Contracting Parties):
   

1. 
   into English:
   

2. 
   into French:
   

3. 
   into Spanish:
   

3. 
    The words contained in the mark have no meaning (and therefore cannot be translated).
   

4. 
   Where applicable, check the relevant box or boxes below:
   

 Sound mark

 Collective mark, certification mark, or guarantee mark

4. 
   Description of the mark (where applicable):
   

4. 
   Verbal elements of the mark (where applicable):
   

4. 
   The applicant declares that he wishes to disclaim protection for the following element(s) of the mark:
   

1. 
   Indicate below the goods and services for which the international registration is sought:
   

Class Goods and services

2. 
    The applicant wishes to limit the list of goods and services in respect of one or more designated Contracting Parties, as follows:
   

Contracting Party Class(es) or list of goods and services for which protection is sought in this Contracting Party

 If the space provided is not sufficient, check the box and use a continuation sheet

(Information concerning national or regional procedures for each Contracting Party designated may be found at the following website: http://www.wipo.int/madrid/en/members/ipoffices_info.html. Additional information may be found in the information notices available at: http://www.wipo.int/madrid/en/notices/)

 AL Albania

 AM Armenia

 AT Austria

 AU Australia

 AZ Azerbaijan

 BA Bosnia and Herzegovina

 BG Bulgaria

 BH Bahrain

 BQ Bonaire, Saint Eustatius and Saba

 BT Bhutan

 BW Botswana

 BX Benelux

 BY Belarus

 CH Switzerland

 CN China

 CU Cuba⁴

 CW Curaçao

 CY Cyprus

 CZ Czech Republic

 DE Germany

 DK Denmark

 EE Estonia

 EG Egypt

 EM European Union¹

 ES Spain

 FI Finland

 FR France

 GB United Kingdom²

 GE Georgia

 GH Ghana⁴

 GR Greece

 HR Croatia

 HU Hungary

 IE Ireland²

 IL Israel

 IR Iran (Islamic Republic of)

 IS Iceland

 IT Italy

 JP Japan⁴

 KE Kenya

 KG Kyrgyzstan

 KP Democratic People’s

Republic of Korea

 KZ Kazakhstan

 LI Liechtenstein

 LR Liberia

 LS Lesotho

 LT Lithuania

 LV Latvia

 MA Morocco

 MC Monaco

 MD Republic of Moldova

 ME Montenegro

 MG Madagascar

 MK The former Yugoslav Rep. of Macedonia

 MN Mongolia

 MZ Mozambique

 NA Namibia

 NO Norway

 OM Oman

 PL Poland

 PT Portugal

 RS Serbia

 RU Russian Federation

 SD Sudan

 SE Sweden

 SG Singapore²

 SI Slovenia

 SK Slovakia

 SL Sierra Leone

 SM San Marino

 ST Sao Tome and Principe

 SY Syrian Arab Republic

 SZ Swaziland

 TJ Tajikistan

 TM Turkmenistan

 TR Turkey

 UA Ukraine

 US United States of America³

 UZ Uzbekistan

 VN Viet Nam

 ZM Zambia

 Saint Martin⁵

Moreover, if the applicant wishes to claim the seniority of an earlier mark registered in, or for, a Member State of the European Union, the official form MM17 must be annexed to the present international application.

(if required or allowed by the Office of origin)

1. 
   Certification
   

(i) that the request to present this application was received, or, as provided in Rule 11(1) of the Regulations, is deemed to have been received, on (dd/mm/yyyy).

that any indication given in item 7(d), 9(d) or 9(e) appears also in the basic registration,

that the mark in item 7(a) is the same as in the basic registration,

that, if color is claimed as a distinctive feature of the mark in the basic registration, the same claim is included in item 8 or that, if color is claimed in item 8 without having being claimed in the basic registration, the mark in the basic registration is in fact in the color or combination of colors claimed, and

that the goods and services listed in item 10 are covered by the list of goods and services appearing in the basic registration.

Where the international application is based on two or more basic registrations, the above declaration shall be deemed to apply to all those basic registrations.

2. 
   Office’s signature:
   

1. 
   INSTRUCTIONS TO DEBIT FROM A CURRENT ACCOUNT
   

Holder of the account: Account number:

Identity of the party giving the instructions:

Complementary fee

100 Swiss francs

Total amount of the

=

Supplementary fee

100 Swiss francs

Total amount of the

=

IBAN No. CH51 0483 5048 7080 8100 0

Credit Suisse, CH-1211 Geneva 70

Swift/BIC: CRESCHZZ80A

IBAN No. CH03 0900 0000 1200 5000 8