Request For Grant Of Patent (Page 2 of 4) in pdf

Request For Grant Of Patent Page 2

III.

INVENTOR :

Applicant is the inventor

Yes

If the applicant is not the inventor :

Name of inventor

OSMAN JAILANI

Address of inventor :

NO. 55, PERSIARAN KERAMAT,

50540 KUALA LUMPUR.

A statement justifying the applicant’s right to the patent accompanies this Form :

Yes

Additional Information (if any)

IV. AGENT OR REPRESENTATIVE :

Applicant has appointed a patent agent in accompanying Form No. 17

Yes

PA 143/94

Agent’s registration No.

Applicant has appointed ….…………………………………………………………………….………………….

to be their representative

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 as 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. DISCLOSURE TO BE REGARDED 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 in more detail the facts concerning the

Yes

disclosure accompanies this Form

Request For Grant Of Patent Page 2