Applicant's or agent's reference
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Full name(s) of applicant(s)
Address(es) of applicant(s)
A single copy of a provisional or two copies of a complete specification of
Drawings of
A copy of Figure
Dated this
PATENTS ACT, 1978
Form P I
APPLICATION FOR A PATENT AND ACKNOWLEDGEMENT OF RECEIPT
[Section 30 (l)-Regulation 22]
(See notes overleaf)
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Revenue stamps or revenue
franking machine impression
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Official date stamp
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(i)
The grant of a patent is hereby requested by the undermentioned applicant on the basis of the present application filed
in duplicate.
Official Application No.
(ii)
71
(Iii)
(iv)
54
Title of invention
(v)
The applicant claims priority as set out on the accompanying form P 2.
(vi)
This application is for a patent of addition to Patient Application No.
(vii)
This application is a fresh application in terms of section 37 and based on Application No.
21
(viii)
This application is accompanied by:
pages.
sheets.
Publication particulars and abstract (form P 8 in duplicate).
of drawings (if any) for the abstract.
An assignment of invention.
Certified priority document(s) (state number).
Translation of the priority document(s).
An assignment of priority rights..
A copy of the form P 2 and the specification of S.A. Patent Application
A declaration and Power of Attorney on form P 3.
Request for ante-dating on form P 4.
Request for classification on form P 9.
(ix)
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Address for service:
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Received
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Official date stamp
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Signature of applicant(s) or agent
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The duplicate will be returned to the applicant's address for service as proof of
lodging but is not valid unless endorsed with official stamp.
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Registrar of Patents
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