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¦ ¦ ¦+--+ ¦ ¦L--- ñì. ïðîäîëæåíèå íà îòäåëüíîì ëèñòå ¦ +----------------------------------------------------------------¦ ¦+--+ ¦ Êîë-âî ¦ Êîë-âî ¦ ¦L--- Ïðèëîæåíèå(ÿ) ê äîâåðåííîñòè: ¦ ýêç. ¦ ñòð. ¦ ¦ +---------+----------¦ ¦ +-+ ¦ ¦ ¦ ¦ L-- ëèñòû äëÿ ïðîäîëæåíèÿ +---------+----------+ ¦ +-+ ¦ ¦ ¦ ¦ L-- äðóãèå äîêóìåíòû (óêàçàòü): L---------+----------+ ¦ ¦ ¦ ¦ +----------------------------------------------------------------¦ ¦ Ïîäïèñü è èìÿ ïîäïèñàâøåãî ¦ ¦ ¦ ¦ Ïå÷àòü ¦ ¦ ¦ ¦ Äàòà ¦ ¦ ¦ +----------------------------------------------------------------+ Ïðèëîæåíèå 2 (â ðåä. Ïðèêàçà Ðîñïàòåíòà îò 19.12.97 N 213) Çàïîëíÿåòñÿ ÔÈÏÑ +---+ Íóæíîå îòìåòèòü çíàêîì ¦ X ¦ +---+ Çàÿâëåíèå ñ ðåêâèçèòàìè, ïðîñòàâëåííûìè ÔÈÏÑ, ÿâëÿåòñÿ óâåäîìëåíèåì î ïîñòóïëåíèè çàÿâêè +----------------------------------------------------------------+ ¦(22) Äàòà ïîñòóïëåíèÿ¦ Âõîäÿùèé N ¦(21) N ãîñ. ðåãèñòðàöèè ¦ +----------------------------------------------------------------¦ ¦ ÇÀßÂÊÀ ¦ ¦ ÍÀ ÐÅÃÈÑÒÐÀÖÈÞ È ÏÐÅÄÎÑÒÀÂËÅÍÈÅ 121858, Ìîñêâà, ¦ ¦ ÏÐÀÂÀ ÏÎËÜÇÎÂÀÍÈß Â ÐÎÑÑÈÉÑÊÎÉ Áåðåæêîâñêàÿ íàá., 30, ¦ ¦ ÔÅÄÅÐÀÖÈÈ ÍÀÈÌÅÍÎÂÀÍÈÅÌ ÌÅÑÒÀ ê. 1 ¦ ¦ ÏÐÎÈÑÕÎÆÄÅÍÈß ÒÎÂÀÐÀ ÔÈÏÑ ¦ +----------------------------------------------------------------¦ ¦ ÇÀßÂËÅÍÈÅ ¦ ¦ ¦ ¦ ¦ ¦ Ïðåäñòàâëÿÿ çàÿâêó è íèæåïåðå÷èñ- ¦Êîä îðãàíèçàöèè, ïðåä- ¦ ¦ëåííûå äîêóìåíòû, ïðîøó çàðåãèñòðèðî- ¦ïðèÿòèÿ ïî ÎÊÏÎ ¦ ¦âàòü óêàçàííîå â çàÿâêå îáîçíà÷åíèå â ¦(åñëè îí óñòàíîâëåí) ¦ ¦êà÷åñòâå íàèìåíîâàíèÿ ìåñòà ïðîèñõîæäå-¦ ¦ ¦íèÿ òîâàðà è ïðåäîñòàâèòü ïðàâî ïîëü- ¦ ¦ ¦çîâàíèÿ èì ¦ ¦ ¦ ¦ ¦ ¦(71) Çàÿâèòåëü: ¦Êîä ñòðàíû ïî ñòàíäàðòó ¦ ¦ ¦ÂÎÈÑ ST.3 ¦ ¦ ¦(åñëè îí óñòàíîâëåí) ¦ ¦(óêàçûâàåòñÿ ïîëíîå íàèìåíîâàíèå þðè- ¦ ¦ ¦äè÷åñêîãî ëèöà (ñîãëàñíî ó÷ðåäèòåëü- ¦ ¦ ¦íîìó äîêóìåíòó) èëè ôàìèëèÿ, èìÿ, îò- ¦ ¦ ¦÷åñòâî ôèçè÷åñêîãî ëèöà) ¦ ¦ +----------------------------------------------------------------¦ ¦+-+ ¦ ¦L-- Ïîëíûé ïî÷òîâûé àäðåñ çàÿâèòåëÿ ¦ ¦ ¦ ¦ Òåëåôîí: Òåëåêñ: Ôàêñ: ¦ +----------------------------------------------------------------¦ ¦(98) Àäðåñ äëÿ ïåðåïèñêè (ïîëíûé ïî÷òîâûé àäðåñ, èìÿ èëè¦ ¦íàèìåíîâàíèå àäðåñàòà) ¦ ¦ ¦ ¦ Òåëåôîí: Òåëåêñ: Ôàêñ: ¦ +----------------------------------------------------------------¦ ¦(74) Ïàòåíòíûé ïîâåðåííûé (ïîëíîå èìÿ, ðåãèñòðàöèîííûé íîìåð,¦ ¦ìåñòîíàõîæäåíèå) ¦ ¦ ¦ ¦ Òåëåôîí: Òåëåêñ: Ôàêñ: ¦ +----------------------------------------------------------------¦ ¦(54) Çàÿâëÿåìîå îáîçíà÷åíèå (ïå÷àòàòü çàãëàâíûìè áóêâàìè) ¦ ¦ ¦ ¦ ¦ +----------------------------------------------------------------¦ ¦Âèä òîâàðà èëè êîíêðåòíûé òîâàð ¦ +----------------------------------------------------------------¦ ¦Îïèñàíèå îñîáûõ ñâîéñòâ òîâàðà ¦ ¦ ¦ ¦ ¦ ¦ ¦ +----------------------------------------------------------------¦ ¦Ìåñòî ïðîèçâîäñòâà (ñ óêàçàíèåì ãðàíèö ãåîãðàôè÷åñêèõ îáúåêòîâ) ¦ ¦ ¦ ¦ ¦ ¦ ¦ +----------------------------------------------------------------¦ ¦Ïåðå÷åíü ïðèëàãàåìûõ äîêóìåíòîâ: ¦êîë-âî ë.¦êîë-âî ¦ ¦ ¦â 1 ýêç. ¦ ýêç. ¦ ¦ +---------+-------¦ ¦ ¦ ¦ ¦ +----------------------------------------------+---------+-------¦ ¦+-+ ¦ ¦ ¦ ¦L-- äîêóìåíò îá óïëàòå ïîøëèíû â óñòàíîâëåííîì¦ ¦ ¦ ¦ ðàçìåðå ¦ ¦ ¦ +----------------------------------------------+---------+-------¦ ¦ ¦ ¦ ¦ +----------------------------------------------+---------+-------¦ ¦+-+ ¦ ¦ ¦ ¦L-- çàêëþ÷åíèå êîìïåòåíòíîãî îðãàíà ¦ ¦ ¦ +----------------------------------------------+---------+-------¦ ¦ ¦ ¦ ¦ +----------------------------------------------+---------+-------¦ ¦+-+ ¦ ¦ ¦ ¦L-- ïåðåâîä íà ðóññêèé ÿçûê äîêóìåíòîâ, ¦ ¦ ¦ ¦ ïðèëàãàåìûõ ê çàÿâêå ¦ ¦ ¦ +----------------------------------------------+---------+-------¦ ¦ ¦ ¦ ¦ +----------------------------------------------+---------+-------¦ ¦+-+ ¦ ¦ ¦ ¦L-- äîâåðåííîñòü, óäîñòîâåðÿþùàÿ ïîëíîìî÷èÿ ¦ ¦ ¦ ¦ ïàòåíòíîãî ïîâåðåííîãî ¦ ¦ ¦ +----------------------------------------------+---------+-------¦ ¦ ¦ ¦ ¦ +----------------------------------------------+---------+-------¦ ¦+-+ ¦ ¦ ¦ ¦L-- äðóãîé äîêóìåíò (óêàçàòü) ¦ ¦ ¦ +----------------------------------------------+---------+-------¦ +----------------------------------------------------------------¦ +----------------------------------------------------------------¦ ¦ Ïîäïèñü ¦ ¦ ¦ ¦ ïîäïèñü çàÿâèòåëÿ èëè ïàòåíòíîãî ïîâåðåííîãî; äàòà ïîäïèñè ¦ ¦ (ïðè ïîäïèñàíèè îò èìåíè þðèäè÷åñêîãî ëèöà ïîäïèñü ¦ ¦ðóêîâîäèòåëÿ óäîñòîâåðÿåòñÿ ïå÷àòüþ) ¦ +----------------------------------------------------------------+ Ïðèëîæåíèå 3 (â ðåä. Ïðèêàçà Ðîñïàòåíòà îò 19.12.97 N 213) Çàïîëíÿåòñÿ ÔÈÏÑ +---+ Íóæíîå îòìåòèòü çíàêîì ¦ X ¦ +---+ Çàÿâëåíèå ñ ðåêâèçèòàìè, ïðîñòàâëåííûìè ÔÈÏÑ, ÿâëÿåòñÿ óâåäîìëåíèåì î ïîñòóïëåíèè çàÿâêè +----------------------------------------------------------------+ ¦(22) Äàòà ïîñòóïëåíèÿ¦ Âõîäÿùèé N ¦(21) N ãîñ. ðåãèñòðàöèè ¦ +----------------------------------------------------------------¦ ¦ ÇÀßÂÊÀ ¦ ¦ ÍÀ ÏÐÅÄÎÑÒÀÂËÅÍÈÅ ÏÐÀÂÀ ÏÎËÜÇÎÂÀÍÈß 121858, Ìîñêâà, ¦ ¦  ÐÎÑÑÈÉÑÊÎÉ ÔÅÄÅÐÀÖÈÈ Áåðåæêîâñêàÿ íàá., 30, ¦ ¦ ÇÀÐÅÃÈÑÒÐÈÐÎÂÀÍÍÛÌ ÍÀÈÌÅÍÎÂÀÍÈÅÌ ê. 1 ¦ ¦ ÌÅÑÒÀ ÏÐÎÈÑÕÎÆÄÅÍÈß ÒÎÂÀÐÀ ÔÈÏÑ ¦ +----------------------------------------------------------------¦ ¦ ÇÀßÂËÅÍÈÅ ¦ ¦ ¦ ¦ ¦ ¦ Ïðåäñòàâëÿÿ çàÿâêó è íèæåïåðå÷èñ- ¦Êîä îðãàíèçàöèè, ïðåä- ¦ ¦ëåííûå äîêóìåíòû, ïðîøó ïðåäîñòàâèòü ¦ïðèÿòèÿ ïî ÎÊÏÎ ¦ ¦ïðàâî ïîëüçîâàíèÿ íàèìåíîâàíèåì ìåñòà ¦(åñëè îí óñòàíîâëåí) ¦ ¦ïðîèñõîæäåíèÿ òîâàðà ¦ ¦ ¦_______________________________________¦ ¦ ¦(óêàçûâàåòñÿ çàðåãèñòðèðîâàííîå â ¦ ¦ ¦Ðîññèéñêîé Ôåäåðàöèè íàèìåíîâàíèå ìåñòঠ¦ ¦ïðîèñõîæäåíèÿ òîâàðà) ¦ ¦ ¦(71) Çàÿâèòåëü: ¦Êîä ñòðàíû ïî ñòàíäàðòó ¦ ¦ ¦ÂÎÈÑ ST.3 ¦ ¦ ¦(åñëè îí óñòàíîâëåí) ¦ ¦(óêàçûâàåòñÿ ïîëíîå íàèìåíîâàíèå þðè- ¦ ¦ ¦äè÷åñêîãî ëèöà (ñîãëàñíî ó÷ðåäèòåëü- ¦ ¦ ¦íîìó äîêóìåíòó) èëè ôàìèëèÿ, èìÿ, îò- ¦ ¦ ¦÷åñòâî ôèçè÷åñêîãî ëèöà) ¦ ¦ +----------------------------------------------------------------¦ ¦+-+ ¦ ¦L-- Ïîëíûé ïî÷òîâûé àäðåñ çàÿ Ïåðåéòè íà ñòð.1Ïåðåéòè íà ñòð.2Ïåðåéòè íà ñòð.3Ïåðåéòè íà ñòð.4ñòð.5Ïåðåéòè íà ñòð.6Ïåðåéòè íà ñòð.7 |