![]() |
| ![]() |
![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() |
¦ ¦ ¦ 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: ¦ +----------------------------------------------------------------¦ ¦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 4 (â ðåä. Ïðèêàçà Ðîñïàòåíòà îò 19.12.97 N 213) +----------------------------------------------------------------+ ¦Îòìåòêà îá óïëàòå ïîøëèíû ¦Äàòà ïîñòóïëåíèÿ â ÔÈÏÑ ¦ ¦ ¦ ¦ ¦ (çàïîëíÿåòñÿ¦ÔÈÏÑ) ¦ +----------------------------------------------------------------¦ ¦ ÇÀßÂËÅÍÈÅ ¦ ¦ Î ÂÍÅÑÅÍÈÈ ÈÇÌÅÍÅÍÈß(É) ¦ ¦ ¦ +----------------------------------------------------------------¦ ¦N äåëà çàÿâèòåëÿ ¦N çàÿâêè ¦ ¦ ¦ ¦ ¦N äåëà ïîâåðåííîãî ¦Äàòà ïîäà÷è ¦ ¦(ïðåäñòàâèòåëÿ) ¦ ¦ +----------------------------------------------------------------¦ ¦Çàÿâèòåëü(è) ¦ ¦ ¦ ¦ ¦ +----------------------------------------------------------------¦ ¦Ïîâåðåííûé (ïðåäñòàâèòåëü) ¦ ¦ ¦ ¦ ¦ +----------------------------------------------------------------¦ ¦Àäðåñ äëÿ ïåðåïèñêè ¦ ¦ ¦ ¦ ¦ +----------------------------------------------------------------¦ ¦Èçìåíåíèå(ÿ) ¦ ¦ ¦ ¦Äàííûå, êîòîðûå ñëåäóåò èçìåíèòü: ¦ ¦ ¦ ¦Äàííûå â èçìåíåííîì âèäå: ¦ ¦ ¦ ¦ ¦ ¦ ¦ ¦ ¦ ¦+--+ ¦ ¦L--- ñì. ïðîäîëæåíèå íà îòäåëüíîì ëèñòå ¦ +----------------------------------------------------------------¦ ¦+--+ +-----------------+ ¦ ¦L--- Ïðèëîæåíèå(ÿ) ê çàÿâëåíèþ ¦ Êîë-âî ¦ Êîë-âî ¦ ¦ ¦ ¦ ýêç. ¦ ñòð. ¦ ¦ ¦ +-+ +--------+--------¦ ¦ ¦ L-- äîêóìåíò îá óïëàòå ïîøëèíû ¦ ¦ ¦ ¦ ¦ +-+ +--------+--------¦ ¦ ¦ L-- ëèñòû äëÿ ïðîäîëæåíèÿ ¦ ¦ ¦ ¦ ¦ +-+ +-----------------+ ¦ ¦ L-- äðóãèå äîêóìåíòû (óêàçàòü): ¦ +----------------------------------------------------------------¦ ¦Ïîäïèñü ¦ ¦ ¦ ¦Ïå÷àòü ¦ ¦ ¦ ¦Äàòà ¦ +----------------------------------------------------------------+ Ïðèëîæåíèå 5 (â ðåä. Ïðèêàçà Ðîñïàòåíòà îò 19.12.97 N 213) +----------------------------------------------------------------+ ¦ ¦Äàòà ïîñòóïëåíèÿ â ÔÈÏÑ ¦ ¦ ¦ ¦ ¦ (çàïîëíÿåòñÿ¦ÔÈÏÑ) ¦ +----------------------------------------------------------------¦ ¦ ÇÀßÂËÅÍÈÅ ¦ ¦ ÎÁ ÈÑÏÐÀÂËÅÍÈÈ ÎØÈÁÊÈ ¦ ¦ (ÎØÈÁÎÊ) ¦ +----------------------------------------------------------------¦ ¦N äåëà çàÿâèòåëÿ ¦N çàÿâêè ¦ ¦ ¦ ¦ ¦N äåëà ïîâåðåííîãî ¦Äàòà ïîäà÷è ¦ ¦(ïðåäñòàâèòåëÿ) ¦ ¦ +----------------------------------------------------------------¦ ¦Çàÿâèòåëü(è) ¦ ¦ ¦ ¦ ¦ +----------------------------------------------------------------¦ ¦Ïîâåðåííûé (ïðåäñòàâèòåëü) ¦ ¦ ¦ ¦ ¦ +----------------------------------------------------------------¦ ¦Àäðåñ äëÿ ïåðåïèñêè ¦ ¦ ¦ ¦ ¦ +----------------------------------------------------------------¦ ¦Îøèáêà(è) è èñïðàâëåíèå(ÿ) ¦ ¦ ¦ ¦Äàííûå, êîòîðûå ñëåäóåò èñïðàâèòü: ¦ ¦ ¦ ¦Äàííûå â èñïðàâëåííîì âèäå: ¦ ¦ ¦ ¦ ¦ ¦ ¦ ¦ ¦ ¦+--+ ¦ ¦L--- ñì. ïðîäîëæåíèå íà îòäåëüíîì ëèñòå ¦ +----------------------------------------------------------------¦ ¦+--+ +-----------------+ ¦ ¦L--- Ïðèëîæåíèå(ÿ) ê çàÿâëåíèþ ¦ Êîë-âî ¦ Ïåðåéòè íà ñòð.1Ïåðåéòè íà ñòð.2Ïåðåéòè íà ñòð.3Ïåðåéòè íà ñòð.4Ïåðåéòè íà ñòð.5ñòð.6Ïåðåéòè íà ñòð.7 |