Application to Register a Patent

e-form Application to Register a Patent

WARNING to all applicants - Any false statements, misrepresentation or concealment of material fact on this form or any document presented in support of this application may be grounds for criminal prosecution. INFORMATION PROTECTED – The Commerce Department collects and processes information provided in this application to carry out its functions under the Patents & Designs Act [Cap. 417]. All data is collected and processed in accordance with the Data Protection Act, Patents & Designs Act [Cap. 417], other legislation and the Privacy Policy of the Department, a copy of which is available on demand. The information provided in this application may also be exchanged with other third parties as provided according to the law. Details of Applicant Full Name Address Postcode Country Telephone Number E-Mail Mobile Number Details of Attorney (if applicable) Full Name Address Postcode Country Telephone Number E-Mail

Details of Inventor(s) Full Name Address Postcode In case there is more than one (1) inventor, please attach the inventors’ list in the attachment section in this application. Details of Priority Claims Date Country Number Details of Invention Title of Invention Number of claims of the Invention Attachments Required documents to be submitted with the application:

-Inventor’s list (if applicable);

-A priority document (if priority is claimed);

-A power of attorney document (if attorney is appointed);

-Abstract;

-Description;

-Claims;

-Drawings / Sketches (if applicable);

Declaration cont. - information in this application form will be published by the Commerce Department and is therefore accessible to the public.

- edited information, that would not identify me, may be used for statistical purposes.

I know that I am entitled to see the information related to me, should I ask for it in writing.

I am aware that for the purposes of the Data Protection Act, the Data Controller is the Director General, Commerce Department.

I declare that before the filing date or where priority is claimed before the date of priority of the application, the invention was not made available to the public in any written or graphic form, by an oral description, by use or in any other way anywhere in the world. Fee and Payment Method Patent Fee: €116.47 Claims Fee For each additional claim when a patent application contains more than 10 claims: €23.29 for each additional claim from the 11th claim onwards Please choose method of payment Bank Transfer Cheque VallettaCoin - click V Image to pay Coins Payment Recipient Transaction ID payasync

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