Hungarian Intellectual Property Office

Hungarian Intellectual Property Office
Budapest
II. János Pál pápa tér 7.
1081
To be filled out by the Office
 
 
 
 
 

 

 

Request for Patent Application

 

 

I request the granting of patent protection on the invention below according to the Act No. XXXIII of 1995

 

1. Title of the invention:

 

 
 

 

 

 

 

2. Applicant (if there are more than one applicant, the data of further applicants shall be indicated on page 2):

 

Family name and first name, or company name

 

Rate of the claim in case of more than one applicant

 

Address (including postal code and in cases of foreigners, country code)

 

Phone/fax

 

 

3. Inventor (to be filled out, if the inventor is not identical to the applicant; the data of further inventors shall be indicated on page 3)

 

Family name and first name, or company name

 

Rate of the claim in case of more than one applicant

 

Address (including postal code and in cases of foreigners, country code)

 

Phone/fax

 

 

4. Representative (to be filled out if the applicant does not proceed personally):

 

Name

 

Phone/fax

 

Address

 

Documents attached to the application:

 

O description with claims ..... copies O power of attorney ..... copies
O number of claims ..... copies O document of succession in title ..... copies
O drawings ..... pieces O document of priority ..... copies
O extract ..... copies O certification of exhibition ..... copies
O other .............................................................         ..... copies

 

2. Applicants (continued): To be filled out only in case of more applicants

 

Family name, first name or company name

 

Rate of the claim

 

Address (including postal code and in cases of foreigners, country code)

 

Phone/fax

 

 

Family name, first name or company name

 

Rate of the claim

 

Address (including postal code and in cases of foreigners, country code)

 

Phone/fax

 

 

Family name, first name or company name

 

Rate of the claim

 

Address (including postal code and in cases of foreigners, country code)

 

Phone/fax

 

 

Family name, first name or company name

 

Rate of the claim

 

Address (including postal code and in cases of foreigners, country code)

 

Phone/fax

 

 

Family name, first name or company name

 

Rate of the claim

 

Address (including postal code and in cases of foreigners, country code)

 

Phone/fax

 

 

Family name, first name or company name

 

Rate of the claim

 

Address (including postal code and in cases of foreigners, country code)

 

Phone/fax

 

 

Family name, first name or company name

 

Rate of the claim

 

Address (including postal code and in cases of foreigners, country code)

 

Phone/fax

 

 

Family name, first name or company name

 

Rate of the claim

 

Address (including postal code and in cases of foreigners, country code)

 

Phone/fax

 

 

Family name, first name or company name

 

Rate of the claim

 

Address (including postal code and in cases of foreigners, country code)

 

Phone/fax

 

 

 

3. Applicants (continued): To be filled out only in case of more applicants if they are not the same with applicants

 

Family name, first name or company name

 

Rate of the claim

 

Address (including postal code and in cases of foreigners, country code)

 

Phone/fax

 

 

Family name, first name or company name

 

Rate of the claim

 

Address (including postal code and in cases of foreigners, country code)

 

Phone/fax

 

 

Family name, first name or company name

 

Rate of the claim

 

Address (including postal code and in cases of foreigners, country code)

 

Phone/fax

 

 

Family name, first name or company name

 

Rate of the claim

 

Address (including postal code and in cases of foreigners, country code)

 

Phone/fax

 

 

Family name, first name or company name

 

Rate of the claim

 

Address (including postal code and in cases of foreigners, country code)

 

Phone/fax

 

 

Family name, first name or company name

 

Rate of the claim

 

Address (including postal code and in cases of foreigners, country code)

 

Phone/fax

 

 

Family name, first name or company name

 

Rate of the claim

 

Address (including postal code and in cases of foreigners, country code)

 

Phone/fax

 

 

Family name, first name or company name

 

Rate of the claim

 

Address (including postal code and in cases of foreigners, country code)

 

Phone/fax

 

 

Family name, first name or company name

 

Rate of the claim

 

Address (including postal code and in cases of foreigners, country code)

 

Phone/fax

 

 

6. Priorities requested (to be filled out only if the application is based on a foreign or national application):

 

In case of Union priority
day country code number
     
     
     
     
     
In case of internal priority
day case number
   
   
   
   
   

 

7. Division, derivation (to be filled out only if necessary):

 

The application which serves as a basis for division
 
case number date
   
   
   
   
   
In case of derivation the case number and the date of the utility model application
case number date
   
   
   
   
   

 

8. Certification of exhibition (to be filled out only if necessary):

 

The designation and date of the exhibition

 
 

 

9. Other communication of the applicant:

 

 
 

 

 

Signature of the applicant, the applicants or the representative 

 

Date  

 
 

 

Number of attachments         copies