MM2

来源机关：国家知识产权局商标局

所属类别：马德里商标国际注册书式 · 来源机关：国家知识产权局商标局 · 文件格式：DOCX

表格内容预览

MM2 (E) – APPLICATION FOR INTERNATIONAL REGISTRATION UNDER THE MADRID PROTOCOL

We strongly recommend that you use eMadrid to submit your international application.

For use by the applicant:	For use by the applicant:

Number of continuation sheets for several applicants:

Number of continuation sheets:

Number of MM17 forms:

MM18 form (if applicable, check the box)	MM18 form (if applicable, check the box)

Applicant’s reference (optional):

For use by the Office of origin:	For use by the Office of origin:

Office’s reference (optional):

1. NAME OF THE OFFICE OF ORIGIN

2. APPLICANT If there is more than one applicant, indicate the number of applicants and complete the “Continuation Sheet for Several Applicants”.	2. APPLICANT If there is more than one applicant, indicate the number of applicants and complete the “Continuation Sheet for Several Applicants”.	2. APPLICANT If there is more than one applicant, indicate the number of applicants and complete the “Continuation Sheet for Several Applicants”.

Number of applicants:	Number of applicants:

(a)	Name:

(b)	Address:	Address:

(c)	E-mail address:	E-mail address:	E-mail address:

(d)	Telephone number:	Telephone number:	Telephone number:

(e)	Nationality or legal nature and State of organization:	Nationality or legal nature and State of organization:	Nationality or legal nature and State of organization:	Nationality or legal nature and State of organization:	Nationality or legal nature and State of organization:	Nationality or legal nature and State of organization:	Nationality or legal nature and State of organization:

	(i)		If the applicant is a natural person, indicate the nationality of the applicant:	If the applicant is a natural person, indicate the nationality of the applicant:	If the applicant is a natural person, indicate the nationality of the applicant:	If the applicant is a natural person, indicate the nationality of the applicant:	If the applicant is a natural person, indicate the nationality of the applicant:
			Nationality of the applicant:	Nationality of the applicant:

	(ii)		If the applicant is a legal entity, provide both of the following indications:	If the applicant is a legal entity, provide both of the following indications:	If the applicant is a legal entity, provide both of the following indications:	If the applicant is a legal entity, provide both of the following indications:	If the applicant is a legal entity, provide both of the following indications:
			Legal nature of the legal entity:	Legal nature of the legal entity:
			State (country) and, where applicable, territorial unit within that State (canton, province, state, etc.), under the law of which the said legal entity has been organized:	State (country) and, where applicable, territorial unit within that State (canton, province, state, etc.), under the law of which the said legal entity has been organized:

Correspondence details (optional):	Correspondence details (optional):	Correspondence details (optional):	Correspondence details (optional):	Correspondence details (optional):	Correspondence details (optional):	Correspondence details (optional):	Correspondence details (optional):

(f)	Preferred language for correspondence:	Preferred language for correspondence:	Preferred language for correspondence:	English	English	French	Spanish

(g)	Alternative address and e-mail address for correspondence:	Alternative address and e-mail address for correspondence:	Alternative address and e-mail address for correspondence:

	(i)	Postal address:






	(ii)	E-mail address:

3. ENTITLEMENT TO FILE	3. ENTITLEMENT TO FILE	3. ENTITLEMENT TO FILE	3. ENTITLEMENT TO FILE	3. ENTITLEMENT TO FILE	3. ENTITLEMENT TO FILE
(a)	Check the appropriate box:	Check the appropriate box:	Check the appropriate box:	Check the appropriate box:	Check the appropriate box:

	(i)		Where the Contracting Party of the Office of origin mentioned in item 1 is a State, the applicant is a national of that State; or	Where the Contracting Party of the Office of origin mentioned in item 1 is a State, the applicant is a national of that State; or	Where the Contracting Party of the Office of origin mentioned in item 1 is a State, the applicant is a national of that State; or

	(ii)		Where the Contracting Party of the Office of origin mentioned in item 1 is an organization, the name of the State of which the applicant is a national:	Where the Contracting Party of the Office of origin mentioned in item 1 is an organization, the name of the State of which the applicant is a national:	Where the Contracting Party of the Office of origin mentioned in item 1 is an organization, the name of the State of which the applicant is a national:
			Where the Contracting Party of the Office of origin mentioned in item 1 is an organization, the name of the State of which the applicant is a national:	Where the Contracting Party of the Office of origin mentioned in item 1 is an organization, the name of the State of which the applicant is a national:	Where the Contracting Party of the Office of origin mentioned in item 1 is an organization, the name of the State of which the applicant is a national:
					; or

	(iii)		The applicant is domiciled in the territory of the Contracting Party of the Office of origin mentioned in item 1; or	The applicant is domiciled in the territory of the Contracting Party of the Office of origin mentioned in item 1; or	The applicant is domiciled in the territory of the Contracting Party of the Office of origin mentioned in item 1; or

	(iv)		The applicant has a real and effective industrial or commercial establishment in the territory of the Contracting Party of the Office of origin mentioned in item 1.	The applicant has a real and effective industrial or commercial establishment in the territory of the Contracting Party of the Office of origin mentioned in item 1.	The applicant has a real and effective industrial or commercial establishment in the territory of the Contracting Party of the Office of origin mentioned in item 1.

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

	(i)	If the box in paragraph (a)(iii) of the present item has been checked, the domicile of the applicant in the territory of the Contracting Party of the Office of origin, or,	If the box in paragraph (a)(iii) of the present item has been checked, the domicile of the applicant in the territory of the Contracting Party of the Office of origin, or,	If the box in paragraph (a)(iii) of the present item has been checked, the domicile of the applicant in the territory of the Contracting Party of the Office of origin, or,	If the box in paragraph (a)(iii) of the present item has been checked, the domicile of the applicant in the territory of the Contracting Party of the Office of origin, or,

	(ii)	If the box in paragraph (a)(iv) of the present item has been checked, the address of the applicant’s industrial or commercial establishment in the territory of the Contracting Party of the Office of origin.	If the box in paragraph (a)(iv) of the present item has been checked, the address of the applicant’s industrial or commercial establishment in the territory of the Contracting Party of the Office of origin.	If the box in paragraph (a)(iv) of the present item has been checked, the address of the applicant’s industrial or commercial establishment in the territory of the Contracting Party of the Office of origin.	If the box in paragraph (a)(iv) of the present item has been checked, the address of the applicant’s industrial or commercial establishment in the territory of the Contracting Party of the Office of origin.






4. APPOINTMENT OF A REPRESENTATIVE	4. APPOINTMENT OF A REPRESENTATIVE	4. APPOINTMENT OF A REPRESENTATIVE	4. APPOINTMENT OF A REPRESENTATIVE	4. APPOINTMENT OF A REPRESENTATIVE	4. APPOINTMENT OF A REPRESENTATIVE
(a)	Name:	Name:	Name:

(b)	Address:	Address:	Address:	Address:	Address:






(c)	E-mail address:	E-mail address:	E-mail address:

(d)	Telephone number:	Telephone number:	Telephone number:

5. BASIC APPLICATION OR BASIC REGISTRATION	5. BASIC APPLICATION OR BASIC REGISTRATION	5. BASIC APPLICATION OR BASIC REGISTRATION	5. BASIC APPLICATION OR BASIC REGISTRATION
Basic application number:		Date of the basic application (dd/mm/yyyy):

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

6. PRIORITY CLAIMED	6. PRIORITY CLAIMED	6. PRIORITY CLAIMED
	The applicant claims the priority of the earlier filing mentioned below:	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, indicate in the space provided below the goods and services to which it does relate:	If the earlier filing does not relate to all the goods and services listed in item 10, indicate in the space provided below the goods and services to which it does relate:


	If several priorities are claimed above, check this box and use a continuation sheet giving the information required for each priority claimed.	If several priorities are claimed above, check this box and use a continuation sheet giving the information required for each priority claimed.

7. THE MARK

(a) Place the representation of the mark as it appears in the basic application or basic registration in the square below; or attach it to this application as a single digital file.

(b)		The applicant declares that the mark is to be considered as a mark in standard characters.

(c)		The mark consists exclusively of a color or a combination of colors as such, without any figurative element.

8. COLOR(S) CLAIMED	8. COLOR(S) CLAIMED	8. COLOR(S) CLAIMED
(a)		The applicant claims color as a distinctive feature of the mark.
		Color or combination of colors claimed:


(b)		Indication, for each color, of the principal parts of the mark that are in that color (as it may be required for certain designations):

9. MISCELLANEOUS INDICATIONS	9. MISCELLANEOUS INDICATIONS	9. MISCELLANEOUS INDICATIONS	9. MISCELLANEOUS INDICATIONS
(a)		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):	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):


(b)		Translation of the mark (as it may be required for certain designations; do not check the box in item (c) if you provide a translation):	Translation of the mark (as it may be required for certain designations; do not check the box in item (c) if you provide a translation):

	(i)	Into English:

	(ii)	Into French:

	(iii)	Into Spanish:

(c)		The words contained in the mark have no meaning (and therefore cannot be translated; do not check this box if you have provided a translation in item (b)).	The words contained in the mark have no meaning (and therefore cannot be translated; do not check this box if you have provided a translation in item (b)).

(d)		Where applicable, check the relevant box(es) below:

		Three-dimensional mark.

		Sound mark.

		Collective mark, certification mark, or guarantee mark.

(e)		Description of the mark (as it may be required for certain designations):

	(i)	Description of the mark contained in the basic application or basic registration, where applicable (only use this item if the Office of origin requires to include this description in the international application for the purposes of item 13(a)(ii) of this form):


	(ii)	Voluntary description of the mark (any description of the mark by words, including the description contained in the basic application or basic registration, if you were not required to provide this description in item (e)(i) above):


(f)		Verbal elements of the mark (where applicable):


(g)		The applicant wishes to disclaim protection for the following element(s) of the mark:

10. GOODS AND SERVICES	10. GOODS AND SERVICES	10. GOODS AND SERVICES	10. GOODS AND SERVICES
(a)			List below the class(es) and goods and services to be covered by the international registration:

Class:	Class:	Class:	Goods and Services:


		If the space provided is not sufficient, check the box and use the continuation sheet for the main list of goods and services.	If the space provided is not sufficient, check the box and use the continuation sheet for the main list of goods and services.

(b)			The applicant wishes to limit the list of goods and services in respect of one or more designations, as follows:	The applicant wishes to limit the list of goods and services in respect of one or more designations, as follows:

Designation:	Designation:	Designation:	Designation:	Class(es) or class(es) and goods and services for this designation:


		If the space provided is not sufficient, check the box and use the continuation sheet for the limited list of goods and services.	If the space provided is not sufficient, check the box and use the continuation sheet for the limited list of goods and services.	If the space provided is not sufficient, check the box and use the continuation sheet for the limited list of goods and services.

11. DESIGNATIONS	11. DESIGNATIONS	11. DESIGNATIONS	11. DESIGNATIONS
Check the corresponding boxes:	Check the corresponding boxes:	Check the corresponding boxes:	Check the corresponding boxes:
AE United Arab Emirates AF Afghanistan AG Antigua and Barbuda AL Albania AM Armenia AT Austria AU Australia AZ Azerbaijan BA Bosnia and Herzegovina BG Bulgaria BH Bahrain BN Brunei Darussalamb BQ Bonaire, Sint Eustatius and Sabaf,g BR Brazilh BT Bhutan BW Botswana BX Beneluxi BY Belarus BZ Belizeb CA Canada CH Switzerland CL Chile CN China CO Colombia CU Cubae CV Cabo Verdeb CW Curaçaof CY Cyprus CZ Czech Republic DE Germany DK Denmark	DZ Algeria EE Estonia EG Egypt EM European Uniona ES Spain FI Finland FR France GB United Kingdomb,j GD Grenada GE Georgia GG Guernseyb,k GH Ghana GM Gambia GR Greece HR Croatia HU Hungary ID Indonesia IE Irelandb IL Israel IN Indiab IR Iran (Islamic Republic of) IS Iceland IT Italy JM Jamaica JP Japan KE Kenya KG Kyrgyzstan KH Cambodia KP Democratic People’s Republic of Korea KR Republic of Korea	KZ Kazakhstan LA Lao People’s Democratic Republic LI Liechtenstein LR Liberia LS Lesothob LT Lithuania LV Latvia MA Morocco MC Monaco MD Republic of Moldova ME Montenegro MG Madagascar MK North Macedonia MN Mongolia MU Mauritius MW Malawib MX Mexico MY Malaysiab MZ Mozambiqueb NA Namibia NO Norway NZ New Zealandb OA African Intellectual Property Organization (OAPI)c OM Oman PH Philippines PK Pakistanb PL Poland PT Portugal QA Qatar	RO Romania RS Serbia RU Russian Federation RW Rwanda SD Sudan SE Sweden SG Singaporeb SI Slovenia SK Slovakia SL Sierra Leone SM San Marino ST Sao Tome and Principe SX Sint Maarten (Dutch part)f SY Syrian Arab Republic SZ Eswatini TH Thailand TJ Tajikistan TM Turkmenistan TN Tunisia TR Türkiye TT Trinidad and Tobagob UA Ukraine US United States of Americad UZ Uzbekistan VN Viet Nam WS Samoa ZM Zambia ZW Zimbabwe

a The designation of the European Union covers its Member States (Austria, Belgium, Bulgaria, Croatia, Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Ireland, Italy, Latvia, Lithuania, Luxembourg, Malta, Netherlands (Kingdom of the), Poland, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden). If the European Union is designated, it is compulsory to indicate a second language before the Office of the European Union, among the following (check one box only): French German Italian Spanish 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. b By designating the Belize, Brunei Darussalam, Cabo Verde, Guernsey, India, Ireland, Lesotho, Malawi, Malaysia, Mozambique, New Zealand, Pakistan, Singapore, Trinidad and Tobago or the United Kingdom, the applicant declares that the applicant has the intention that the mark will be used by the applicant or with the applicant’s consent in that country/territory in connection with the goods and services identified in this application. c The designation of the African Intellectual Property Organization (OAPI) covers the following Member States: Benin, Burkina Faso, Cameroon, Central African Republic, Chad, Comoros, Congo, Côte d’Ivoire, Equatorial Guinea, Gabon, Guinea, Guinea-Bissau, Mali, Mauritania, Niger, Senegal, Togo. d If the United States of America is designated, it is compulsory to annex to the present international application the official form MM18 containing the declaration of intention to use the mark required by this Contracting Party. Item 2(e) of the present form should also be completed. e Cuba has made a notification under Rule 34(3)(a) of the Regulations (individual fees payable in two parts). Therefore, if Cuba is designated, only the first part of the applicable individual fee is payable at the time of filing the present international application. The second part will have to be paid only if the Office is satisfied that the mark which is the subject of the international registration qualifies for protection. The date by which the second part must be paid, and the amount due, will be notified to the holder of the international registration at a later stage. f Territorial entity previously part of the former Netherlands Antilles. g Protection in BQ (Bonaire, Sint Eustatius and Saba) is granted automatically with the designation (see Information Notice No. 27/2011). h By designating Brazil, the applicant declares that the applicant, or a company controlled by the applicant, effectively and lawfully conducts business in connection with the goods and services for which Brazil is being designated; and, agrees to receive notifications, including summons, not covered by the Madrid Protocol concerning the international registration of the mark that is the subject of this international application, issued in judicial proceedings held in Brazil, by post. i The designation of Benelux covers the following States: Belgium, Luxembourg and Netherlands (Kingdom of the). j The designation of the United Kingdom covers England, Wales, Scotland, Northern Ireland, the British Overseas Territory of the Falkland Islands (Malvinas) and Gibraltar, as well as the two British Crown Dependencies of the Isle of Man and Jersey (see Information Notices No. 38/2015 and 77/2020). k The Bailiwick of Guernsey is a self-governing British Crown Dependency (see Information Notice No. 77/2020).

12. SIGNATURE OF THE APPLICANT AND/OR THEIR REPRESENTATIVE If required or allowed by the Office of origin.	12. SIGNATURE OF THE APPLICANT AND/OR THEIR REPRESENTATIVE If required or allowed by the Office of origin.

By signing this form, I declare that I am entitled to sign it under the applicable law:	By signing this form, I declare that I am entitled to sign it under the applicable law:
Signature:

13. CERTIFICATION AND SIGNATURE OF THE INTERNATIONAL APPLICATION BY THE OFFICE OF ORIGIN	13. CERTIFICATION AND SIGNATURE OF THE INTERNATIONAL APPLICATION BY THE OFFICE OF ORIGIN	13. CERTIFICATION AND SIGNATURE OF THE INTERNATIONAL APPLICATION BY THE OFFICE OF ORIGIN
(a)		Certification. The Office of origin certifies:

	(i)	That the request to present this application was received on (dd/mm/yyyy):


	(ii)	That the applicant named in item 2 is the same as the applicant named in the basic application or the holder named in the basic registration mentioned in item 5, as the case may be, that any indication given in item 7(c), 9(d) or 9(e)(i) appears also in the basic application or the basic registration, as the case may be, that the mark in item 7(a) corresponds to the mark in the basic application or the basic registration, as the case may be, that, if color is claimed as a distinctive feature of the mark in the basic application or the basic registration, or the mark in the basic application or basic registration is applied to be or is protected in color, a color claim is included in item 8 or that, if color is claimed in item 8 without having being claimed in the basic application or basic registration, the mark in the basic application or 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 application or basic registration, as the case may be.

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

(b)		Name of the Office:


(c)		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.


(d)		E-mail address of the contact person in the Office:

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.	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.	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.	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.	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.	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	INSTRUCTIONS TO DEBIT FROM A CURRENT ACCOUNT AT WIPO	INSTRUCTIONS TO DEBIT FROM A CURRENT ACCOUNT AT WIPO	INSTRUCTIONS TO DEBIT FROM A CURRENT ACCOUNT AT WIPO	INSTRUCTIONS TO DEBIT FROM A CURRENT ACCOUNT AT WIPO

	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 item (b)).	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 item (b)).	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 item (b)).	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 item (b)).	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 item (b)).

Holder of the account:	Holder of the account:
Account number:	Account number:
Identity of the party giving the instructions:	Identity of the party giving the instructions:

(b)	BANK OR POSTAL TRANSFER	BANK OR POSTAL TRANSFER	BANK OR POSTAL TRANSFER	BANK OR POSTAL TRANSFER	BANK OR POSTAL TRANSFER

Identity of the party effecting the payment:	Identity of the party effecting the payment:	Identity of the party effecting the payment:

Payment received and acknowledged by WIPO	Payment received and acknowledged by WIPO	Payment received and acknowledged by WIPO		WIPO receipt number	WIPO receipt number
Payment received and acknowledged by WIPO	Payment received and acknowledged by WIPO	Payment received and acknowledged by WIPO
Payment made to WIPO bank account Account name: WIPO Bank: UBS SWITZERLAND AG, ZURICH, SWITZERLAND IBAN: CH77 0024 0240 FP10 1035 6 Swift: UBSWCHZH80A	Payment made to WIPO bank account Account name: WIPO Bank: UBS SWITZERLAND AG, ZURICH, SWITZERLAND IBAN: CH77 0024 0240 FP10 1035 6 Swift: UBSWCHZH80A	Payment made to WIPO bank account Account name: WIPO Bank: UBS SWITZERLAND AG, ZURICH, SWITZERLAND IBAN: CH77 0024 0240 FP10 1035 6 Swift: UBSWCHZH80A		Payment identification	dd/mm/yyyy
Payment made to WIPO bank account Account name: WIPO Bank: UBS SWITZERLAND AG, ZURICH, SWITZERLAND IBAN: CH77 0024 0240 FP10 1035 6 Swift: UBSWCHZH80A	Payment made to WIPO bank account Account name: WIPO Bank: UBS SWITZERLAND AG, ZURICH, SWITZERLAND IBAN: CH77 0024 0240 FP10 1035 6 Swift: UBSWCHZH80A	Payment made to WIPO bank account Account name: WIPO Bank: UBS SWITZERLAND AG, ZURICH, SWITZERLAND IBAN: CH77 0024 0240 FP10 1035 6 Swift: UBSWCHZH80A
Payment made to WIPO postal account (within Europe only) Account name: WIPO / OMPI SWISS POST/Postfinance, Engelhaldenstrasse 37, CH-3030 Bern IBAN: CH03 0900 0000 1200 5000 8 Swift: POFICHBE	Payment made to WIPO postal account (within Europe only) Account name: WIPO / OMPI SWISS POST/Postfinance, Engelhaldenstrasse 37, CH-3030 Bern IBAN: CH03 0900 0000 1200 5000 8 Swift: POFICHBE	Payment made to WIPO postal account (within Europe only) Account name: WIPO / OMPI SWISS POST/Postfinance, Engelhaldenstrasse 37, CH-3030 Bern IBAN: CH03 0900 0000 1200 5000 8 Swift: POFICHBE		Payment identification	dd/mm/yyyy
Payment made to WIPO postal account (within Europe only) Account name: WIPO / OMPI SWISS POST/Postfinance, Engelhaldenstrasse 37, CH-3030 Bern IBAN: CH03 0900 0000 1200 5000 8 Swift: POFICHBE	Payment made to WIPO postal account (within Europe only) Account name: WIPO / OMPI SWISS POST/Postfinance, Engelhaldenstrasse 37, CH-3030 Bern IBAN: CH03 0900 0000 1200 5000 8 Swift: POFICHBE	Payment made to WIPO postal account (within Europe only) Account name: WIPO / OMPI SWISS POST/Postfinance, Engelhaldenstrasse 37, CH-3030 Bern IBAN: CH03 0900 0000 1200 5000 8 Swift: POFICHBE

FEE CALCULATION SHEET	FEE CALCULATION SHEET	FEE CALCULATION SHEET	FEE CALCULATION SHEET	FEE CALCULATION SHEET	FEE CALCULATION SHEET	FEE CALCULATION SHEET
AMOUNT OF FEES (see the Madrid System Fee Calculator)	AMOUNT OF FEES (see the Madrid System Fee Calculator)	AMOUNT OF FEES (see the Madrid System Fee Calculator)	AMOUNT OF FEES (see the Madrid System Fee Calculator)	AMOUNT OF FEES (see the Madrid System Fee Calculator)	AMOUNT OF FEES (see the Madrid System Fee Calculator)	AMOUNT OF FEES (see the Madrid System Fee Calculator)

Basic fee: 653 Swiss francs if the representation of the mark is in black and white and 903 Swiss francs if the representation is in color. (For international applications filed by applicants whose country of origin is a Least Developed Country, in accordance with the list established by the United Nations, 65 Swiss francs if the representation is in black and white and 90 Swiss francs if the representation is in color.)	Basic fee: 653 Swiss francs if the representation of the mark is in black and white and 903 Swiss francs if the representation is in color. (For international applications filed by applicants whose country of origin is a Least Developed Country, in accordance with the list established by the United Nations, 65 Swiss francs if the representation is in black and white and 90 Swiss francs if the representation is in color.)	Basic fee: 653 Swiss francs if the representation of the mark is in black and white and 903 Swiss francs if the representation is in color. (For international applications filed by applicants whose country of origin is a Least Developed Country, in accordance with the list established by the United Nations, 65 Swiss francs if the representation is in black and white and 90 Swiss francs if the representation is in color.)	Basic fee: 653 Swiss francs if the representation of the mark is in black and white and 903 Swiss francs if the representation is in color. (For international applications filed by applicants whose country of origin is a Least Developed Country, in accordance with the list established by the United Nations, 65 Swiss francs if the representation is in black and white and 90 Swiss francs if the representation is in color.)	Basic fee: 653 Swiss francs if the representation of the mark is in black and white and 903 Swiss francs if the representation is in color. (For international applications filed by applicants whose country of origin is a Least Developed Country, in accordance with the list established by the United Nations, 65 Swiss francs if the representation is in black and white and 90 Swiss francs if the representation is in color.)	Basic fee: 653 Swiss francs if the representation of the mark is in black and white and 903 Swiss francs if the representation is in color. (For international applications filed by applicants whose country of origin is a Least Developed Country, in accordance with the list established by the United Nations, 65 Swiss francs if the representation is in black and white and 90 Swiss francs if the representation is in color.)

Complementary and supplementary fees:	Complementary and supplementary fees:	Complementary and supplementary fees:	Complementary and supplementary fees:	Complementary and supplementary fees:	Complementary and supplementary fees:	Complementary and supplementary fees:
Number of designations for which complementary fee is applicable	Number of designations for which complementary fee is applicable	Complementary fee	Total amount of the complementary fees	Total amount of the complementary fees
	x	100 Swiss francs	=		=
Number of classes of goods and services beyond three	Number of classes of goods and services beyond three	Supplementary fee	Total amount of the supplementary fees	Total amount of the supplementary fees
	x	100 Swiss francs	=		=

Individual fees (Swiss francs):	Individual fees (Swiss francs):	Individual fees (Swiss francs):	Individual fees (Swiss francs):	Individual fees (Swiss francs):	Individual fees (Swiss francs):	Individual fees (Swiss francs):
Designations	Designations	Individual fee	Designations	Designations	Individual fee	Individual fee







		Total individual fees	Total individual fees	Total individual fees	=

		GRAND TOTAL (Swiss francs)	GRAND TOTAL (Swiss francs)	GRAND TOTAL (Swiss francs)	=

CONTINUATION SHEET FOR SEVERAL APPLICANTS

No.

Please, complete a separate continuation sheet for each applicant.

APPLICANT

No.

(a)

Name:

(b)

Address:

(c)

E-mail address:

(d)

Telephone number:

(e)

Nationality or legal nature and State of organization:

(i)

If the applicant is a natural person, indicate the nationality of the applicant:

Nationality of the applicant:

(ii)

If the applicant is a legal entity, provide both of the following indications:

Legal nature of the legal entity:

State (country) and, where applicable, territorial unit within that State (canton, province, state, etc.), under the law of which the said legal entity has been organized:

ENTITLEMENT TO FILE	ENTITLEMENT TO FILE	ENTITLEMENT TO FILE	ENTITLEMENT TO FILE	ENTITLEMENT TO FILE
(a)	Check the appropriate box:	Check the appropriate box:	Check the appropriate box:	Check the appropriate box:

	(i)		Where the Contracting Party of the Office of origin mentioned in item 1 of the attached form is a State, the applicant is a national of that State; or	Where the Contracting Party of the Office of origin mentioned in item 1 of the attached form is a State, the applicant is a national of that State; or

	(ii)		Where the Contracting Party of the Office of origin mentioned in item 1 of the attached form is an organization, the name of the State of which the applicant is a national:	Where the Contracting Party of the Office of origin mentioned in item 1 of the attached form is an organization, the name of the State of which the applicant is a national:
			Where the Contracting Party of the Office of origin mentioned in item 1 of the attached form is an organization, the name of the State of which the applicant is a national:	Where the Contracting Party of the Office of origin mentioned in item 1 of the attached form is an organization, the name of the State of which the applicant is a national:
				; or

	(iii)		The applicant is domiciled in the territory of the Contracting Party of the Office of origin mentioned in item 1 of the attached form; or	The applicant is domiciled in the territory of the Contracting Party of the Office of origin mentioned in item 1 of the attached form; or

	(iv)		The applicant has a real and effective industrial or commercial establishment in the territory of the Contracting Party of the Office of origin mentioned in item 1 of the attached form.	The applicant has a real and effective industrial or commercial establishment in the territory of the Contracting Party of the Office of origin mentioned in item 1 of the attached form.

(b)	Where the address of the applicant given above is not in the territory of the Contracting Party of the Office of origin mentioned in item 1 of the attached form, indicate in the space provided below:	Where the address of the applicant given above is not in the territory of the Contracting Party of the Office of origin mentioned in item 1 of the attached form, indicate in the space provided below:	Where the address of the applicant given above is not in the territory of the Contracting Party of the Office of origin mentioned in item 1 of the attached form, indicate in the space provided below:	Where the address of the applicant given above is not in the territory of the Contracting Party of the Office of origin mentioned in item 1 of the attached form, indicate in the space provided below:

	(i)	If the box in paragraph (a)(iii) above has been checked, the domicile of the applicant in the territory of the Contracting Party of the Office of origin, or	If the box in paragraph (a)(iii) above has been checked, the domicile of the applicant in the territory of the Contracting Party of the Office of origin, or	If the box in paragraph (a)(iii) above has been checked, the domicile of the applicant in the territory of the Contracting Party of the Office of origin, or

	(ii)	If the box in paragraph (a)(iv) above has been checked, the address of the applicant’s industrial or commercial establishment in the territory of the Contracting Party of the Office of origin.	If the box in paragraph (a)(iv) above has been checked, the address of the applicant’s industrial or commercial establishment in the territory of the Contracting Party of the Office of origin.	If the box in paragraph (a)(iv) above has been checked, the address of the applicant’s industrial or commercial establishment in the territory of the Contracting Party of the Office of origin.

CONTINUATION SHEET FOR THE MAIN LIST OF GOODS AND SERVICES	CONTINUATION SHEET FOR THE MAIN LIST OF GOODS AND SERVICES	CONTINUATION SHEET FOR THE MAIN LIST OF GOODS AND SERVICES	No.		of

List below the class(es) and goods and services to be covered by the international registration:	List below the class(es) and goods and services to be covered by the international registration:	List below the class(es) and goods and services to be covered by the international registration:	List below the class(es) and goods and services to be covered by the international registration:	List below the class(es) and goods and services to be covered by the international registration:	List below the class(es) and goods and services to be covered by the international registration:	List below the class(es) and goods and services to be covered by the international registration:

Class:	Class:	Goods and Services:	Goods and Services:	Goods and Services:	Goods and Services:	Goods and Services:

CONTINUATION SHEET FOR THE LIMITED LIST OF GOODS AND SERVICES	CONTINUATION SHEET FOR THE LIMITED LIST OF GOODS AND SERVICES	CONTINUATION SHEET FOR THE LIMITED LIST OF GOODS AND SERVICES	CONTINUATION SHEET FOR THE LIMITED LIST OF GOODS AND SERVICES	No.		of

The applicant wishes to limit the list of goods and services in respect of one or more designations, as follows:	The applicant wishes to limit the list of goods and services in respect of one or more designations, as follows:	The applicant wishes to limit the list of goods and services in respect of one or more designations, as follows:	The applicant wishes to limit the list of goods and services in respect of one or more designations, as follows:	The applicant wishes to limit the list of goods and services in respect of one or more designations, as follows:	The applicant wishes to limit the list of goods and services in respect of one or more designations, as follows:	The applicant wishes to limit the list of goods and services in respect of one or more designations, as follows:	The applicant wishes to limit the list of goods and services in respect of one or more designations, as follows:

Designation:	Designation:	Designation:	Class(es) or class(es) and goods and services for this designation:	Class(es) or class(es) and goods and services for this designation:	Class(es) or class(es) and goods and services for this designation:	Class(es) or class(es) and goods and services for this designation:	Class(es) or class(es) and goods and services for this designation:

CONTINUATION SHEET	No.	of

MM2

同类别文书