MM10 (E) – REQUEST FOR THE RECORDING OF A CHANGE IN THE NAME AND/OR ADDRESS OF THE REPRESENTATIVE
We strongly recommend that you use eMadrid to request the recording of a change of name and/or address of the representative.
This form is to be used only to request the recording of a change in the name and/or address of the recorded representative and not to appoint a new representative.
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| 1. INTERNATIONAL REGISTRATION NUMBER(S)This form may be used for several international registrations of the same representative. |
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| 2. NAME OF THE REPRESENTATIVEAs recorded in the International Register. |
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| (a) | Name: | |
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| (b) | Address: |
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| 3. CHANGE IN NAME AND/OR ADDRESS OF THE REPRESENTATIVE |
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| (a) | New name: | |
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| (b) | New address: |
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| (c) | New e-mail address: | |
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| (d) | New telephone number: | |
| 4. SIGNATURE OF THE HOLDER AND/OR THEIR REPRESENTATIVE |
| Holder (as recorded in the International Register): |
| By signing this form, I declare that I am entitled to sign it under the applicable law: |
| Name: | |
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| Signature: | |
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| Representative of the holder (as recorded in the International Register): |
| By signing this form, I declare that I am entitled to sign it under the applicable law: |
| Name: | |
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| Signature: | |
| 5. SIGNATURE OF THE OFFICE PRESENTING THE REQUESTWhere the request is presented through an Office. |
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| (a) | Name of the Office: |
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| (b) | Name and signature of the official signing on behalf of the Office: |
| By signing this form, I declare that I am entitled to sign it under the applicable law: |
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| (c) | E-mail address of the contact person in the Office: |
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