Ethiopian Science And Technology Commission Schedule Forms II | GOALGOOLE | Because you need Information for your goals !
7023 Bole Kifle Ketema, Addis Ababa, Ethiopia
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Ethiopian Science And Technology Commission Schedule Forms II

Form No.1 Regulations No. 12/1997

 

REQUEST FOR GRANT OF

PATENT OR UTILITY

MODEL CERTIFICATE

TO: The Ethiopian Science and

Technology Commission

P.O.Box 2490

Tel. 251-1-51-13-44

Telex 21568 ESTC ET

Fax 251-1-518829

Addis Ababa Ethiopia

 

For Office Use

Date of receipt

By the Commission:

 

Application No.:

(Commission’s stamp)

 

 

 

Filing date:

Applicant’s or

representative’s file

reference

 

 

patent

 

The Applicant(s) request(s) the grant of a

 

 

utility model certificate in respect of the following particulars:

  1. TITLE OF INVENTION/MINOR INVENTION:

 

 

  1. applicant(s) (The data concerning each applicant must appear in this box or, if the space is insufficient, in the supplemental box.)

Name:

Address:

Nationality:

Country of residence or principal place of business:

Tel.No:                                                                   Telegraphic address:

Telex No.:                                                               Fax No.:

 

 

 

 

III. AGENT

The following agent has been appointed by the applicant (s)

 

 

The power of attorney accompanies this form

 

 

The power of attorney will be filed within one month from the filing of this form.

Name:

Address:

 

Tel. No:                                                                        Telex No.:

Telegraphic Address:                                                    Fax No.:

 

 

  1. INVENTOR

 

 

The inventor is the applicant

Additional information is contained in the supplemental box

If the inventor is not the applicant the inventors:

Name:

Address:

 

 

The statement justifying the applicant’s right accompanies this form

  1. DIVISIONAL APPLICATION

 

 

 

This application is a divisional application

The benefit of the           filing date          priority

Date of the initial application is claimed in as much as the subject matter of the present application is contained in the initial application identified below.

Initial Application No.:

Date of filing of initial application:

  1. DISCLOSURES TO BE DISREGARDED FOR PRIOR ART PURPOSES

Disclosure occurred not ore than twelve months before the filling date or priority date of the present application;

 

 

by reason or in consequence of acts of the applicant or his predecessor in title.

 

 

 

of an abuse committed by a third party with regard to the rights of the applicant or his predecessor in title.

additional information is contained in a statement accompanying this form

 

 

 

 

 

VII.   PRIORITY DECLARATION (If any)

 

 

The priority of (an) earlier application (s) is clamied as follows

 

 

The priority of more than one earlier application is claimed; the data are indicated in the supplemental box

Country(if the earlier application is a regional or international application, indicate the office with which and the countries for which it was filed):

Filing date:

Application No.:

Symbol of the International

patent Classification:

 

 

not yet allocated

The certified copy of the earlier application

 

 

accompanies this form

 

 

will be furnished upon request by the Commission, as prescribed by Article 20(5) of the regulations.

The translation into English or Amharic of the earlier applications

 

 

accompanies this form

 

 

will be furnished upon request by the Commission, as prescribed by Article 20(5) of the regulations.

VIII. SUPPLEMENTAL BOX* ..

 

 

 

 

 

IX. CHECK LIST (TO BE FILLED IN BY THE APPLICANT)

(A) This application contains

the following:

1. request ……………… sheet(s)

 

2. description …………. Sheet(s)

 

3. claim(s)……………… sheet(s)

 

4. abstract ……………… sheet(s)

 

5. drawing(s) …………… sheet(s)

TOTAL ——————– SHEETS

 

_________________________________

(C)   Figure number ……………. Of

the drawings (if any) is

suggested to accompany

the abstract for

publication

(B) This form, as filed,

is accompanied by the

items ticked below:

 

 

separate singed power

of at torn

 

 

statement justifying

the applicant’s right

statement that certain

 

 

disclosures be

disregarded

 

 

priority document(s)

(Certified copy of

earlier applications(s))

 

 

translation of earlier

application (s) on

which priority declaration

is based into

(English or Amharic)

 

 

application fee

 

 

 

 

 

 

 

 

 

other document(s)

(specify)

 

  1. SIGNATURE(S)** ………………………….. date ……………………….

To be filled in by the Commission

1.       Date of receipt of corrections or later filed documents completing the application:

__________________________________________________________

2.      date fees received:

 

*  Use this box if any of the boxes is not large enough to contain information to be furnished. Indicate the boxes continued in this box by their roman numerals and title (e.g, “II. Applicant(s) (continued)”. If more space is needed, use and attach separate sheet(s) and make reference thereto in the supplement box.

* *  Type name(s) under signature
(form No.1, fourth and last page)