Form 12

The Patents and Design Act, 2020

First Schedule (Section 85(1))

Application to registration a design

1. Your Reference :

2. Classes:

Select The Clasess
Select The Sub-Clasess
No Items Added as Yet !

3. Applicant:

Applicant's Name:
Address of Applicant

No Items Added as Yet !

Your Application details, including your name and address, will appear on our records in the office, which are searchable by the public

If you are applying in the name of company, where is it incorporated?

4. Agent:

Name of your Agent(if you have one)
Address of Agent:
Agent Email:

5. Total Fees:

Total Cost:

6. Contact:

Contact Name:
Contact Address:
Contact Email Address:
Contact Telephone:
Mobile Telephone:

7. Name of the Applicant

8. Products

Enter Products
How many illustration sheets are there for this design?

9. Illustration

Illustration Sheets:

10. RSP (Repeat Surface on Product) if this is the design of a pattern which repeat across the surface of the product

is this a RSP Product?

11. Description

Brief Description of the design shown in the illustation or sample:

12. Limitation

List Any Limitations you want to record:

13. Publication

Have you included priority documents with this application?

14. Priority Information

Should this design be published or deferred?

15. Claiming Priority from an earlier application?

Application Number:
Date of Filing (dd/MM/yyy)
Country

16. If an earlier applicaiton was made in a different name ?

Please state how the current application has a right to apply:
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