MM6 (E) – REQUEST FOR THE RECORDING OF A LIMITATION OF THE LIST OF GOODS AND SERVICES
We strongly recommend that you use eMadrid to request a limitation of the list of goods and services.
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| 1. INTERNATIONAL REGISTRATION NUMBER(S)This form may be used for several international registrations in the name of the same holder, provided that the same limitation applies to all designated Contracting Parties or to the same designated Contracting Parties for each of the international registrations concerned. |
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| 2. NAME OF THE HOLDERAs recorded in the International Register. |
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| 3. E-MAIL ADDRESS OF THE HOLDER AND THE REPRESENTATIVEYou must indicate the e-mail address of the holder and representative (if applicable) only if these addresses have not already been provided for the international registration(s) indicated in item 1 of this form. If an e-mail address has already been provided, any e-mail address indicated below will be disregarded. |
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| (a) | Email address of the holder: | |
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| (b) | Email address of the representative: | |
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| 4. CONTRACTING PARTIESCheck only one box. |
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| (a) | | The limitation of the list of goods and services indicated in item 5(a) and/or 5(b) is to be recorded for all the Contracting Parties designated in the international registration(s) indicated in item 1. |
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| (b) | | The limitation of the list of goods and services indicated in item 5(a) and/or 5(b) is to be recorded for the designated Contracting Parties indicated below: |
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| 5. GOODS AND SERVICESAny class covered by the international registration(s) indicated in item 1 that is not mentioned below remains as recorded in the International Register: –if you want to request the recording of a limitation for one particular class in respect of the designated Contracting Parties mentioned in item 4, provide the relevant class number and the complete new limited list of goods and services of this class under item (a); – however, if you want to delete one or more entire classes in respect of those Contracting Parties, indicate the class number(s) under item (b). |
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| (a) | If the limitation concerns changes in a given class, provide below the relevant class number and the complete new limited list of goods and services of this class (i.e., not the goods or services that you wish to delete from the currently recorded list): |
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| (b) | If an entire class is to be deleted, indicate only the class number (if a class number is indicated here, it will be understood that the designation of the Contracting Parties indicated in item 4 no longer contains this class. Any class mentioned under item 5(a), above, must not be indicated here.): |
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| If the space provided is not sufficient, check the box and use a continuation sheet. |
| 6. 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: |
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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: |
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| 7. 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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| METHOD OF PAYMENT If you want to debit the amount of the fees from your Current Account at WIPO, tick the box and provide the information under item (a). If you have already transferred those amounts to WIPO’s bank or postal account, provide as much information as possible under item (b), which would allow WIPO to identify and allocate your payment. |
| (a) | INSTRUCTIONS TO DEBIT FROM A CURRENT ACCOUNT AT WIPO |
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| The International Bureau is hereby instructed to debit the required amount of fees from a current account opened with WIPO (if this box is checked, it is not necessary to complete (b)). |
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| Holder of the account: | |
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| Identity of the party giving the instructions: | |
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| (b) | BANK OR POSTAL TRANSFER |
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| Identity of the party effecting the payment: | |
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| Payment received and acknowledged by WIPO | | WIPO receipt number |
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| Payment made to WIPO bank accountAccount name: WIPOBank: UBS SWITZERLAND AG, ZURICH, SWITZERLANDIBAN: CH77 0024 0240 FP10 1035 6 Swift: UBSWCHZH80A | | Payment identification | dd/mm/yyyy |
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| Payment made to WIPO postal account (within Europe only)Account name: WIPO / OMPISWISS POST/Postfinance, Engelhaldenstrasse 37, CH-3030 BernIBAN: CH03 0900 0000 1200 5000 8Swift: POFICHBE | | Payment identification | dd/mm/yyyy |
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| FEE CALCULATION SHEET |
| AMOUNT OF FEES |
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| Amount (177 Swiss francs) | x | | (per international registration mentioned in item 1) | GRAND TOTAL (Swiss francs) | = | |
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