11. Designated Contracting Parties:
Please tick the countries in which protection is sought
AG Antigua and Barbuda
BA Bosnia and Herzegovina
BN Brunei Darussalam
BQ Bonaire, Saint Eustatius
CZ Czech Republic
EM European Union
IR Iran (Islamic Republic of)
KP Democratic people’s
Republic of Korea
KR Republic of Korea
LA Lao People’s
MD Republic of Moldova
MK North Macedonia
NZ New Zealand
OA African Intellectual
RU Russian Federation
SL Sierra Leone
SM San Marino
ST Sao Tome and Principe
SX Sint Maarten (Dutch part)
SY Syrian Arab Republic
US United States of America
VN Viet Nam
1. The designation of the European Union covers the following Member States: Austria, Belgium, Bulgaria, Croatia, Cyprus, Czech Republic, Denmark,
Estonia, Finland, France, Germany, Greece, Hungary, Ireland, Italy, Latvia, Lithuania, Luxembourg, Malta, The Netherlands, Poland, Portugal,
Romania, Slovakia, Slovenia, Spain, Sweden, United Kingdom.
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. The MM17 can be found at http://www.wipo.int/madrid/en/forms/
2. By designating Brunei Darussalam, India, Ireland, New Zealand or Singapore, the applicant declares that he has the intention that the mark will
be used by him or with his consent in that country in connection with the goods and services identiﬁed in this application.
3. The designation of the African Intellectual Property Organization 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.
4. 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. Section 2 (further information) of the present form should also be
completed. The MM18 can be found at http://www.wipo.int/madrid/en/forms/. We would advise you to ﬁle the MM18 with the MM2. Otherwise,
you will need to send the form directly to the International Bureau (WIPO).
Cuba and Japan have made a notiﬁcation under Rule 34(3)(a) of the Common Regulations. Their respective individual fees are payable in
two parts. Therefore, if Cuba or Japan 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 of the Contracting Party concerned 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.
6. Territorial entity previously part of the former Netherlands Antilles.