REPUBLIC OF SOUTH AFRICA
FORM P.3
PATENTS ACT, 1978
DECLARATION AND POWER OF ATTORNEY
(Section 30 - Regulation 8, 22(i)(c) and 33)
PATENT APPLICATION NO
REF:
LODGING DATE
21
01
22
FULL NAME(S) OF APPLICANT(S)
71
FULL NAME(S) OF INVENTOR(S)
72
EARLIEST PRIORITY CLAIMED
COUNTRY
DATE
33
31
32
NOTE: The country must be indicated by its International Abbreviation - see schedule 4 of the Regulations
TITLE OF INVENTION
54
*
.
hereby declare that :-
*
1.
I/we am/are the applicant(s) mentioned above;
**
2.
stated in the capacity of
I/we have been authorized by the applicant(s) to make this declaration and have knowledge of the facts herein
of the applicant(s);
***
3.
the inventor(s) of the abovementioned invention is/are the person(s) named above and the applicant(s) has/have
acquired the right to apply by virtue of an assignment from the inventor(s);
4.
to the best of my/our knowledge and belief, if a patent is granted on the application, there will be no lawful
ground for the revocation of the patent;
5.
this is a convention application and the earliest application from which priority is claimed as set out above is the
first application in a convention country in respect of the invention claimed in any of the claims; and
16.
the partners and qualified staff of the firm of
, patent attorneys, are authorised, jointly and severally,
with powers of substitution and revocation, to represent the applicant(s) in this application and to be the address
for service of the applicant(s) while the application is pending and after a patent has been granted on the
application.
SIGNED AT
THIS
DAY OF
20
SIGNATURE(S)
(no legalization necessary)
In the case of application in the name of a company, partnership or firm, give full names of signatory/signatories, delete paragraph 1, and enter capacity
**
of each signatory
***
If the applicant is a natural person, delete paragraph 2.
If the right to apply is not by virtue of an assignment from the inventor(s), delete
*an assignmnt from the inventw(s)'
and give details of acquisition of right.
For non-convenuon applications, delete paragraph 5.
