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Правила составления, подачи и рассмотрения заявки на регистрацию и предоставление права пользования наименованием места происхождения товара и заявки на предоставление права пользования ... (с изменениями на 19 декабря 1997 года) (утратили силу)

Приложение 4

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¦Отметка об уплате пошлины            ¦Дата поступления во ФИПС    ¦
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¦                         (заполняется¦ФИПС)                       ¦
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¦                            ЗАЯВЛЕНИЕ                             ¦
¦                     о внесении изменения(й)                      ¦
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¦N дела заявителя                     ¦N заявки                    ¦
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¦N дела поверенного                   ¦                            ¦
¦(представителя)                      ¦Дата подачи                 ¦
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¦Заявитель(и)                                                      ¦
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¦Поверенный (представитель)                                        ¦
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¦Адрес для переписки                                               ¦
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¦Изменение(я)                                                      ¦
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¦Данные, которые следует изменить:                                 ¦
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¦Данные в измененном виде:                                         ¦
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¦+-+                                                               ¦
¦+-+ см. продолжение на отдельном листе                            ¦
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¦+-+                                              ¦Кол-во ¦  Кол-во¦
¦+-+ Приложение(я) к заявлению                    ¦экз.   ¦  стр.  ¦
¦                                                 +-------+--------¦
¦  +-+                                            +-------+--------¦
¦  +-+ документ об уплате пошлины                 +----------------¦
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¦  +-+                                                             ¦
¦  +-+ листы для продолжения                                       ¦
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¦  +-+                                                             ¦
¦  +-+ другие документы (указать):                                 ¦
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¦Подпись                                                           ¦
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¦Печать                                                            ¦
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¦Дата                                                              ¦
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