Annex IV Reduction of United States Individual Designation Fee

International Design Applications (Hague Agreement)

form_dm_1_annex_IV

Application for International Registration (Private Sector Respondents)

OMB: 0651-0075

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DM/1/IV (E)

ANNEX IV:
REDUCTION OF UNITED STATES INDIVIDUAL DESIGNATION FEE
under Section 408(b) of the Administrative Instructions

IMPORTANT
1. This cover sheet is only relevant for the designation of the United States of America and is mandatory
content if the applicant claims micro entity status in the DM/1 form. It cannot be submitted alone.
2. This document is to submit a certification following Section 408(b) of the Administrative Instructions.
3. The certification form (PTO/SB/15A or PTO/SB/15B), along with the instructions for its completion and
signature, is available on the United States Patent and Trademark Office web site:
www.uspto.gov/forms/aia_forms.jsp.
4. Please number your pages.

For use by the applicant

For use by the International Bureau

This Annex concerns the international application
referenced by the applicant as below:

Document type: DDE
Contracting Party: US

Reference:

IV

REDUCTION OF INDIVIDUAL DESIGNATION FEES

Number of pages:

(including this cover page)

World Intellectual Property Organization
34, chemin des Colombettes, P.O. Box 18,
1211 Geneva 20, Switzerland
Tel.: +41 (0)22 338 9111
Internet: www.wipo.int
Contact Hague

DM/1/IV (E) – January 2019


File Typeapplication/pdf
File TitleForm DM/1 (Hague System for the International Registration of Industrial Designs)
SubjectApplication for International Registration Governed Exclusively or Partly by the 1999 Act and/or the 1960 Act
AuthorWIPO
File Modified2019-01-16
File Created2019-01-16

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