Form MM6 (Madrid Agreement Concerning the International by Noodlezs

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									                                                                                                                            MM6(E)
                                MADRID AGREEMENT AND PROTOCOL CONCERNING THE

                                         INTERNATIONAL REGISTRATION OF MARKS




                                            REQUEST FOR THE RECORDING OF A

                                  LIMITATION OF THE LIST OF GOODS AND SERVICES

                                                 (Rule 25 of the Common Regulations)




                                                            IMPORTANT

                 1.   This request may be presented to the International Bureau directly by the holder or by the Office of
                 the Contracting Party of the holder.

                 2.    The goods and services affected by this limitation may be the subject of a subsequent designation
                 and therefore will continue to be taken into account in the calculation of the supplementary fees at the time
                 of renewal. If these goods and services are to be permanently removed from the International Register, the
                 recording of a cancellation should be requested instead (form MM8). In such a case, those goods and
                 services may no longer be the subject of a subsequent designation and will not be taken into account in the
                 calculation of the supplementary fees at the time of renewal.

                 3.    One single form may be used to request the recording of one limitation for several international
                 registrations, provided that the holder is the same and the same limitation applies to all designated
                 Contracting Parties or to the same designated Contracting Parties for each of the international registrations
                 concerned.




                                              World Intellectual Property Organization
                                             34, chemin des Colombettes, P.O. Box 18,
                                                    1211 Geneva 20, Switzerland
                                                       Tel.: (41-22) 338 9111
                                     Fax (International Trademark Registry): (41-22) 740 1429
                                   e-mail: intreg.mail@wipo.int – Internet: http://www.wipo.int




MM6(E) – XI.03
                                                                                                                                  MM6(E)
REQUEST FOR THE RECORDING OF A LIMITATION OF THE LIST OF GOODS AND SERVICES
                          For use by the holder                                                        For use by the holder/Office

 This request contains, in addition to this form, the following number of        Holder’s reference:
 continuation sheets:                                                            Office’s reference:


  1      INTERNATIONAL REGISTRATION NUMBER(S)




  2      NAME OF THE HOLDER
         (as recorded in the International Register)




 3       APPOINTMENT OF A REPRESENTATIVE
         (do not complete this item if there is no change in the representative already recorded in the International Register)

         Name:

         Address:
                                                                               Telephone:

         Fax:                                                                  E-mail address:


         SIGNATURE OF THE HOLDER APPOINTING THE ABOVE (NEW) REPRESENTATIVE




 4       CONTRACTING PARTIES
         (check only one box)

         (a)         the limitation of the list of goods and services indicated in item 5(a) and/or 5(b) is to be recorded for all the Contracting
                     Parties designated in the international registration(s) indicated in item 1; or

         (b)         the limitation of the list of goods and services indicated in item 5(a) and/or 5(b) is to be recorded for the designated
                     Contracting Parties indicated below:




MM6(E) – XI.03
                                                                                                                                                    Page 2


   5     GOODS AND SERVICES
         (do not mention the same class in more than one field)

         WARNING: It shall be understood that any class covered by the international registration concerned, which is
         not mentioned in (a) or (b) below, is NOT affected by the limitation and remains therefore unchanged.

         (a)     Entire class(es), if any, affected by the limitation (for which protection is no longer sought) (specify only the numbers of the
                 class(es) concerned), and/or




         (b)     If the limitation affects only some of the goods or services in a given class, indicate those goods or services under (i) and/or (ii), as
                 the case may be:

                 (i)    goods or services for which protection is no longer sought, grouped in the appropriate classes (it shall be understood that any
                        remaining goods or services within the class concerned are NOT affected by the limitation); and/or




                 (ii)   goods or services to be restricted as follows:
                        (this item must be completed when the limitation takes the form of a different (and narrower) wording of a given good or
                        service, for example: “Class 16: Office requisites, except furniture”. It shall be understood that any remaining goods or
                        services within the class concerned are NOT affected by the limitation)




                 If the space provided is not sufficient, check the box and use a continuation sheet




MM6(E) – XI.03
                                                                                                     Page 3


 6       SIGNATURE BY THE HOLDER OR HIS REPRESENTATIVE

         Holder                                        Representative of the holder
         (as recorded in the International Register)   (as recorded in the International Register)

         Name:                                         Name:

         Signature:                                    Signature:


  7      OFFICE PRESENTING THE REQUEST
         (if applicable)

         Name of the Office



         Signature and/or stamp of the Office




MM6(E) – XI.03
                                                                                                                                          Page 4

                                                               FEE CALCULATION SHEET


 (a)   INSTRUCTIONS TO DEBIT FROM A CURRENT ACCOUNT

       The International Bureau is hereby instructed to debit the required amount of fees from a current account opened with the International
       Bureau (if this box is checked, it is not necessary to complete (b)).

 Holder of the account:                                                                        Account number:

 Identity of the party giving the instructions:


 (b)   AMOUNT OF FEES; METHOD OF PAYMENT

       Amount (177 Swiss francs) x                (per international registration
                                                   mentioned in item 1)           Grand total (Swiss francs)

 Identity of the party effecting the payment:
                                                                      WIPO receipt number

 Payment received and acknowledged by WIPO
                                                                      Cheque identification                        dd/mm/yyyy

 Payment made by banker’s cheque (attached)
                                                                      Cheque identification                        dd/mm/yyyy

 Payment made by banker’s cheque (sent separately)

 Payment made to WIPO bank account
 No. CH35 0425 1048 7080 8100 0                                       Payment identification                       dd/mm/yyyy

 Credit Suisse, CH-1211 Geneva 70
 Swift: CRESCH ZZ12A

 Payment made to WIPO postal cheque account                           Payment identification                       dd/mm/yyyy

 No 12-5000-8, Geneva




MM6(E) – XI.03
                 CONTINUATION SHEET   No: .......... of ..........




MM6(E) – XI.03

								
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