SCHEDULE II- (Regulations 29) [Form No.13- 21] (PATENTS REGULATIONS 1986

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Malaysia Legislation

P.U.(A) 327/86
PATENTS REGULATIONS 1986

SCHEDULE II [Form No.13- 21]

Patents Form No 13 PATENTS ACT 1983 REQUEST FOR CANCELLATION OF COMPULSORY LICENCE (Regulation 41 (2)) To: The Registrar of Patents Patent Registration Office Kuala Lumpur Malaysia	For Official Use APPLICATION NO: ...................................... Filing Date: ...................................... Request received on: ...................................... Fee received on: ...................................... Amount: ...................................... *Cheque/Postal/ Order/Money Order/ Draft/Cash No: ......................................
	Date of mailing: ......................................
Please submit one copy of this Form together with the prescribed fee.	Applicant's or Agents file reference ......................................

I IN THE MATTER OF:

Patent No: ...................................... Date of Grant: ......................................
and the compulsory licence relating thereto.
______________________________________________________________________________

II PATENT OWNER(S) :

Name: ......................................

Address : ......................................
______________________________________________________________________________

III REQUEST
The above patent owner(s) ask(s) the Registrar to transmit to the Board the present request for the cancellation of the compulsory licence identified above upon the grounds set out below.
______________________________________________________________________________

IV **STATEMENT OF GROUNDS attached.
______________________________________________________________________________

V ADDITIONAL INFORMATION accompanies this Form:

Yes _____ No _____
______________________________________________________________________________

VI SIGNATURE ................................................. ...........................

***(Patent Owner / Agent) (Date)

If Agent, indicate Agent's Registration No: ......................................
______________________________________________________________________________

*Delete whichever does not apply.
**The ground upon which the request is based shall be indicated by a reference to the statutory provision the applicant considers applicable (section 54 (2)(a) or 54 (2)(b) or 54 (2)(c) or 54 (2)(d) of the Patents Act 1983) and to the facts he considers as justifying the cancellation of a compulsory licence.
***Type name under signature and delete whichever does not apply.
______________________________________________________________________________

Patents Form No 14 PATENTS ACT 1983 APPLICATION FOR GRANT OF CERTIFICATE FOR UTILITY INNOVATION (Regulation 45 (1)) To: The Registrar of Patents Patent Registration Office Kuala Lumpur Malaysia	For Official Use APPLICATION NO: ...................................... Filing Date: ...................................... Application received on: ...................................... Fee received on: ...................................... Amount: ...................................... *Cheque/Postal Order/Money Order/ Draft/Cash No: ......................................
	Date of mailing: ......................................
Please submit this Form in duplicate together with the prescribed fee.	Applicant's or Agent's file reference ......................................

THE APPLICANT(S) REQUEST(S) THE GRANT OF A CERTIFICATE FOR A UTILITY

INNOVATION IN RESPECT OF THE FOLLOWING PARTICULARS:

I TITLE OF INVENTION : ......................................
______________________________________________________________________________

II APPLICANT(s) (the data concerning each applicant must appear in this box or, if the space is insufficient, in the space below) :

Name: ......................................
I/C Passport No: ......................................
Address:......................................
Address for service in Malaysia:
......................................
Nationality: ......................................

* Permanent residence or principal place of business:
............................................................................

Telephone Number
(if any)
..........................................

Fax Number
(if any)
..........................................

_______________________________________________________________________________

III INNOVATOR:
Applicant in the innovator

Yes ____ No____

If the applicant is not the innovator.
Name of innovator : ..........................................
Address of innovator : .......................................

A statement justifying the applicant's right to the certificate accompanies this Form:

Yes ____ No ____

IV AGENT or REPRESENTATIVE:

Applicant has appointed a patent agent
in accompanying Form No 17

Yes____ No ____

Agent's Registration No: ..........................................
Applicants have appointed .......................................... to be their common representative
______________________________________________________________________________

V 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 in the subject-matter of the present application is contained in the initial application identified below.

Initial Application No: ..........................................
Date of filing of initial application: ..........................................
______________________________________________________________________________

VI DISCLOSURES TO BE DISREGARDED FOR PRIOR ART PURPOSES:

Additional information is contained in supplemental box:

(a) Disclosure was due to acts of applicant or his predecessor in title

Date of disclosure:...........................................................................

(b) Disclosure was due to abuse of rights of applicant or his predecessor in title

Date of disclosure :.........................................................................

A statement specifying m more detail the facts concerning the disclosure accompanies this Form

Yes _____
No _____

______________________________________________________________________________

VII PRIORITY CLAIM (if any) :

The priority of an earlier application in claimed as follows:

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

Filing Date: ..........................................
Application No: ..........................................

Symbol of the International Patent Classification:

If not yet allocated, please tick _____

The priority of more than one earlier application is claimed:

Yes ____ No ____

The certified copy of the earlier application (s) accompanies this Form:

Yes ____ No ____

If No, it will be furnished by .......................................... (date)
______________________________________________________________________________

VIII CHECK LIST

A This application contains the following

1. request
2. description ............................... sheets
3. claim .......................................... sheets
4. abstract ...................................... sheets
5. drawings .................................... sheets

Total ....................................... sheets

B This Form, as filed, is accompanied by the items checked below:

(a) signed Form No 17 _____

(b) declaration that innovator does not wish to be named in the certificate _____

(c) statement justifying applicant's right to the certificate _____

(d) statement that certain disclosures be disregarded ______

(e) priority document (certified copy of earlier application) ______

(I) cash, cheque, money order banker's draft or postal order for the payment of application fee _____

(g) other documents (specify) _____
______________________________________________________________________________

IX SIGNATURE .......................................... ..........................................

**(Applicant /Agent) (Date)

If Agent, indicate Agent's Registration No: ..........................................

For Official Use

1 Date application received: ..........................................

2 Date of receipt of correction, later filed papers or drawings completing the application:......................... ______________________________________________________________________________

*Delete whichever does not apply.
**Type name under signature and delete whichever does not apply.
______________________________________________________________________________

Patents Form No 15 PATENTS ACT 1983 APPLICATION TO EXTEND TERM OF CERTIFICATE FOR UTILITY INNOVATION (Regulation 45 (2) ) To: The Registrar of Patents Patent Registration Office Kuala Lumpur Malaysia	For Official Use APPLICATION NO: .......................................... Filing Date: .......................................... Application received on: .......................................... Fee received on: .......................................... Amount: .......................................... *Cheque/Postal Order/Money Order/ Draf/Cash No: ..........................................
	Date of mailing: ..........................................
Please submit one copy of this Form together with the prescribed fee.	Applicant's or Agent's file reference ...........................................................................

I IN THE MATTER OF:

Certificate No: .......................................... Date of Grant: ..........................................

II APPLICANT(s) (The data concerning each applicant must appear in this box or, if the space is insufficient, in the space below)

Name : ..........................................
Address : ..........................................
Address for service in Malaysia: ..........................................

Telephone Number
(if any)
..........................................

Fax Number
(if any)
..........................................

_______________________________________________________________________________

III APPLICATION

The owner of the Certificate applies for an extension of the term of the Certificate for an additional period of five years.
______________________________________________________________________________

IV AFFIDAVIT:

An affidavit showing. that the utility innovation is in commercial or industrial use in Malaysia satisfactorily explaining its non-use is attached in accordance with section 35 (3) of the Patents Act 1983.
______________________________________________________________________________

V ADDITIONAL INFORMATION accompanies this Form:

Yes _____ No _____
______________________________________________________________________________

VI SIGNATURE ..................................................... .............................

**(Owner(s) / Agent (Date)

If Agent, indicate Agent's Registration No: ..........................................
______________________________________________________________________________

*Delete whichever does not apply.
**Type name under signature and delete whichever does not apply.
______________________________________________________________________________

Patents Form No 16 PATENTS ACT 1983 REQUEST TO AMEND APPLICATION FOR GRANT OF PATENT (Regulations 46 and 45 (3) ) To: The Registrar of Patents Patent Registration Office Kuala Lumpur Malaysia	For Official Use APPLICATION NO: .......................................... Filing Date: .......................................... Request received on: .......................................... Fee received on: .......................................... Amount: .......................................... *Cheque/Postal Order/Money Order/ Draft/Cash No: ..........................................
	Date of mailing: ..........................................
Please submit one copy of this Form together with the prescribed fee.	Applicant's or Agent's file reference ..........................................

I IN THE MATTER OF:

Patent Application No: .......................................... Filing Date: ..........................................
Certificate Application No: .................................. Filing Date: ..........................................
Other documents (identify) : ..........................................
______________________________________________________________________________

II PERSON(S) MAKING REQUEST

Name : ..........................................
Address : ..........................................

Address for service in Malaysia:..........................................

Telephone Number
(if any)
..........................................

Fax Number
(if any)
..........................................

_______________________________________________________________________________

III REQUEST:

The person(s) above-identified request(s) the Registrar that, after *his/ their paying the prescribed fee, the clerical error or obvious mistake in the document identified above may, in accordance with section 79 of the Patents Act 1983, be corrected as attached.
______________________________________________________________________________

IV ADDITIONAL INFORMATION accompanies this Form:

Yes ____ No ____
______________________________________________________________________________

VI SIGNATURE: ............................................. .......................................

**(Applicant / Agent) (Date)

If Agent, indicate Agents Registration No: ..........................................
______________________________________________________________________________

*Delete whichever does not apply.
**Type name under signature and delete whichever does not apply.
______________________________________________________________________________

.

Patents Form No 16A PATENTS ACT 1983 REQUEST TO AMEND PATENT (Regulations 46A and 45 (3)) To: The Registrar of Patents Patent Registration Office Kuala Lumpur Malaysia	For Official Use APPLICATION: .......................................... Filing Date: .......................................... Request received on: .......................................... Fee received on: .......................................... Amount: .......................................... *Cheque/Postal Order/Money Order/ Draft/Cash No: ..........................................
	Date of mailing: ..........................................
Please submit one copy of this Form together with the prescribed fee.	Applicant's or Agent's file reference ..........................................

I IN THE MATTER OF:

Patent No: .......................................... Date of Grant: ..........................................
Certificate No: .................................. Date of Grant: ..........................................
______________________________________________________________________________

II OWNER(S) :

Name:..........................................
Address: .....................................
______________________________________________________________________________

III ASSOCIATED DOCUMENT (if any) :

Document: ..........................................
______________________________________________________________________________

IV REQUEST

The owner(s) request(s) the Registrar to amend, as attached, the above identified *patent/certificate/document in accordance with section 79A(1) of the Patents Act 1983.
______________________________________________________________________________

V REASON FOR REQUEST:

*(a) Correction of clerical error

(b) Correction of obvious mistake

..........................................

______________________________________________________________________________

VI ADDITIONAL INFORMATION accompanies this Form:

Yes ____ No _____
______________________________________________________________________________

VI SIGNATURE .......................................... ..........................................

***(Applicant /Agent) (Date)

If Agent, indicate Agent's Registration No: ..........................................
______________________________________________________________________________

*Delete whichever does not apply.
**Specify other reason
***Type name under signature and delete whichever does not apply.
______________________________________________________________________________

Patents Form No 17 PATENTS ACT 1983 APPOINTMENT OR CHANGE OF PATENT AGENT (Regulations 45B (2) and 45 (3)) To: The Registrar of Patents Patents Registration Office Kuala Lumpur Malaysia	For Official Use APPLICATION NO: .......................................... Filing Date: ........................................................ Received on: ......................................................
	Date of mailing : ..........................................
Please submit one copy of this Form.	Applicant's or Agents file reference ..........................................

*I/We the undersigned,

Name: ..........................................
Address: ..........................................
appoint
Name: ..........................................
Address:..........................................

Telephone Number
(if any)
..........................................

Fax Number
(if any)
..........................................

to act as *my/our agent in connection with the following matter(s) :
..........................................................................................................
ratify all acts done by the agent on *my/our behalf in connection with *that/ those matter(s), and request that all notices, requisitions and communications relating thereto be sent to the agent at the abovementioned said address.

Any previous appointment in respect of the same matter(s) is revoked.

**SIGNATURE .......................................... ..........................................

(Date)

______________________________________________________________________________

*Delete whichever does not apply.
**Must be signed by the person(s) appointing the agent; type name under signature.
______________________________________________________________________________

Patents Form No 18 PATENTS ACT 1983 APPLICATION FOR REGISTRATION OF PATENT AGENTS (Regulation 45C (1) ) To: The Registrar of Patents Patent Registration Office Kuala Lumpur Malaysia	For Official Use Application received on: .......................................... Fee received on: .......................................... Amount: .......................................... *Cheque/Postal/ Order/Money Order/ Draft/Cash No: ..........................................
Please submit one copy of this Form together with the prescribed fee.	Applicant's file reference ..........................................

I APPLICANT:

Name:..........................................
Address: ..........................................
Nationality : ..........................................

* Permanent residence or principal place of business:
..........................................

Telephone Number
(if any)
..........................................

Fax Number
(if any)
..........................................

______________________________________________________________________________

II Application

The above applicant applies for registration as a patent agent in the Register of Patents Agents.
______________________________________________________________________________

III QUALIFICATIONS:

The applicant (tick whichever is applicable) :

(a) is an advocate and solicitor of the High Court _____

(b) has passed the examination specified in regulation 45D _____

(c) has a relevant degree or its equivalent in engineering or science ______

(d) has not been convicted of any offence involving fraud or dishonesty _____

(e) has been convicted of an offence involving fraud or dishonesty and a record thereof with a statement of explanation accompanies this Form _____
______________________________________________________________________________

IV Proof of the matters specified in paragraphs (a), (b), (c) and (d) of Part III of this Form, if applicable, accompanies this Form.
______________________________________________________________________________

V SIGNATURE ............................................. .......................................**(Applicant) (Date)

______________________________________________________________________________

*Delete whichever does not apply

**Type name under signature.

______________________________________________________________________________

Patents Form No 18A PATENTS ACT 1983 APPLICATION FOR REGISTRATION AS CANDIDATE FOR EXAMINATION (Regulation 45D (2)) To: The Registrar of Patents Patent Registration Office Kuala Lumpur Malaysia	For Official Use Application received on: .......................................... Fee received on: .......................................... Amount: .......................................... *Cheque/Postal/ Order/Money Order/ Draft/Cash No: ......................................
please submit this Form in duplicate together with the prescribed fee.	Applicant's file reference ..........................................

I I ..........................................of ....................................................................... hereby apply for registration as a candidate at the Examination for Registration as Patent Agents to be held in the month of .......................................20...........
..........................................
______________________________________________________________________________

II SIGNATURE ........................................... ..............................

**(Applicant) (Date)

Telephone Number Fax Number

(if any) (if any)

..................................... ................................

______________________________________________________________________________

*Delete whichever does not apply.
**Type name under signature.

______________________________________________________________________________

Patents Form No 18B PATENTS ACT 1983 APPLICATION TO RE-SIT EXAMINATION (Regulation 45D (8) ) To: The Secretary Board of Examiners of Patent Agents Patent Registration Office Kuala Lumpur Malaysia	For Official Use Application received on: ........................................... Fee received on: ........................................... Amount: ........................................... *Cheque/Postal Order/Money Order/ Draft/Cash No: ...........................................
Please submit this Form in duplicate be together with the prescribed fee.	Applicant's file reference ...........................................

I I ........................................... of ....................................................................................................................... hereby apply to
submit myself to re-sit the examination in the following subject (s) at the Examination for Registration as Patent
Agents to be held in the month of ........................................... 20 ...........................................
Subjects :...........................................
______________________________________________________________________________

SIGNATURE ........................................... ...........................................

**(Applicant) (Date)

Telephone Number
(if any)
..........................................
<BR>

Fax Number
(if any)
..........................................

______________________________________________________________________________

*Delete whichever does not apply.
**Type name under signature.
______________________________________________________________________________

Patents Form No 19 PATENTS ACT 1983 APPLICATION FOR RENEWAL OF REGISTRATION OF PATENT AGENT (Regulation 45E (1)) To: The Registrar of Patents Patent Registration Office Kuala Lumpur Malaysia	For Official Use Application received on: ........................................... Fee received on: ........................................... Amount: ........................................... *Cheque/Postal Order/Money Order/ Draft/Cash No: ...........................................
Please submit one copy of this Form together with the prescribed fee.	Applicant's file reference . . . . . . . . . . . . . . . . . . .

1 APPLICANT:
Name : ...........................................
Address : ...........................................
Nationality :...........................................
* Permanent residence or domicile: ...........................................

Telephone Number
(if any)
..........................................
<BR>

Fax Number
(if any)
..........................................

______________________________________________________________________________

II APPLICATION.

The above applicant applies for renewal of the registration in the
Register of Patents Agents.
______________________________________________________________________________

III QUALIFICATIONS:

The applicant (tick whichever is applicable) :

(a) is an advocate and solicitor of the High Court _____

(b) has passed the examination specified in regulation 45D _____

(c) has a relevant degree or its equivalent in engineering or science _____

(d) has not been convicted of any offence involving fraud or dishonesty ______

(e) has been convicted of an offence involving fraud or dishonesty and a record thereof with a statement of explanation accompanies this Form ______
______________________________________________________________________________

IV ADDITIONAL INFORMATION accompanies this Form:

Yes ____ No _____
______________________________________________________________________________

V SIGNATURE ........................................... ......................................

**(Applicant) (Date)

______________________________________________________________________________

*Delete whichever does not apply.
**Type name under signature.
______________________________________________________________________________

Patents Form No 20 PATENTS ACT 1983 FURNISHMENT OF ADDRESS FOR SERVICE (Regulations 51 and 45 (3)) To: The Registrar of Patents Patent Registration Office Kuala Lumpur Malaysia	For Official Use Request No: ...................................... Fee received On: ...................................... Received on : ...................................... Amount: ...................................... *Cheque/Postal Order/Money Order/ Draft/Cash No: ......................................
	Date of mailing: ......................................
Please submit one copy of this Form together with the prescribed fee.	Applicant's or Agent's file reference ......................................

I IN THE MATTER OF:

Patent Application No: .................. Filing Date: ......................................
Patent No: ...................................... Date of Grant: ...................................
Certificate Application No: ........... Filing Date: ......................................
Certificate No: ............................... Date of Grant: ...................................
______________________________________________________________________________

II APPLICANT(s) :

Name: ...................................
Address: ...................................
______________________________________________________________________________

III REQUEST

The applicant (s) identified above request(s) the Registrar for the inclusion/addition/alteration/substitution of an address for service in Malaysia as follows:
...................................
______________________________________________________________________________

IV ADDITIONAL INFORMATION accompanies this Form:

Yes ____ No ____
______________________________________________________________________________

V SIGNATURE ................................... .................................

**(Applicant / Agent) (Date)

If Agent, indicate Agent's Registration No: ...................................
______________________________________________________________________________

*Delete whichever does not apply.
**Type name under signature and delete whichever does not apply.
______________________________________________________________________________

Patents Form No 21 PATENTS ACT 1983 REQUEST FOR EXTENSION OF TIME (Regulations 53 (1) and 45 (3)) To: The Registrar of Patents Patent Registration Office Kuala Lumpur Malaysia	For Official Use APPLICATION NO: ................................... Filing Date: ................................... Request received on: ................................... Fee received on: ................................... Amount: ................................... *Cheque/Postal Order/Money Order/ Draft/Cash No: ...................................
	Date of mailing: ...................................
Please submit this Form in duplicate together with the prescribed fee.	Applicant's or Agent's file reference ...................................

I IN THE MATTER OF:

Patent Application No: ............... Filing Date: ...................................

Patent No: ................................... Date of Grant: ...............................

Certificate Application No:......... Filing Date: ...................................

Certificate No: ............................. Date of Grant: ...............................
______________________________________________________________________________

II APPLICANT(S) :

Name: ...................................
Address: ...................................
______________________________________________________________________________

III REQUEST:

**The applicant(s) request(s) the Registrar to extend the time within
which to:
...................................
______________________________________________________________________________

IV EXTENSION PERIOD SHRUGGED.

From: ................................... To: ...................................
______________________________________________________________________________

V ***STATEMENT OF GROUNDS attached ______
______________________________________________________________________________

VI ADDITIONAL INFORMATION accompanies this Form:

Yes ____ No ____
______________________________________________________________________________

VII SIGNATURE ........................................ .......................................

****Applicant /Agent) (Date)

If Agent, indicate Agents Registration No: ...................................
______________________________________________________________________________

**Insert brief description of the act or things to be done.
***The applicant shall state the facts he considers as justifying the extension.
****Type name under signature and delete whichever does not apply.