MM4(e) Designation Subsequent to the International Registration

Madrid Protocol

form_mm4-editable1 2022

Application for Subsequent Designation (Private Sector)

OMB: 0651-0051

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MM4 (E) – DESIGNATION SUBSEQUENT TO THE INTERNATIONAL
REGISTRATION
We strongly recommend that you use the online subsequent designation form to request a
subsequent designation when paying the subsequent designation fees with a credit card or
debiting them from a WIPO current account.
For use by the holder:
Number of continuation sheets:
Number of MM17 forms:
MM18 form (if applicable, check the box)
Holder’s reference:
For use by the Office of origin:
Office’s reference:
1. INTERNATIONAL REGISTRATION NUMBER

2. NAME OF THE HOLDER1
As recorded in the International Register.

1

Where the international registration is jointly owned, indicate the names of each joint holder as recorded in
the international registration here.

MM4 (E) – March 2022

MM4 (E), page 2
3. DESIGNATIONS2
Check the corresponding boxes:
AE United Arab
Emirates
AF Afghanistan
AG Antigua and
Barbuda
AL Albania
AM Armenia
AT Austria
AU Australia
AZ Azerbaijan
BA Bosnia and
Herzegovina
BG Bulgaria
BH Bahrain
BN Brunei
Darussalamb
BQ Bonaire,
Saint
Eustatius and
Sabaf,g
BR Brazile,h,i
BT Bhutan
BW Botswana
BX Beneluxj
BY Belarus
CA Canada
CH Switzerland
CN China
CO Colombia
CU Cubae
CW Curaçaof
CY Cyprus
CZ Czech
Republic
DE Germany
DK Denmark

2

DZ
EE
EG
EM

Algeria
Estoniah
Egypt
European
Uniona
ES Spain
FI Finland
FR France
GB United
Kingdomb,k
GE Georgia
GG Guernseyb,l
GH Ghana
GM Gambia
GR Greece
HR Croatia
HU Hungary
ID Indonesia
IE Irelandb
IL Israel
IN Indiab,h
IR Iran (Islamic
Republic of)
IS Iceland
IT Italy
JM Jamaica
JP Japane
KE Kenya
KG Kyrgyzstan
KH Cambodia
KP Democratic
People’s
Republic of
Korea
KR Republic of
Korea

KZ Kazakhstan
LA Lao People’s
Democratic
Republic
LI Liechtenstein
LR Liberia
LS Lesothob
LT Lithuania
LV Latvia
MA Morocco
MC Monaco
MD Republic of
Moldova
ME Montenegro
MG Madagascar
MK North
Macedonia
MN Mongolia
MW Malawib
MX Mexico
MY Malaysiab
MZ Mozambiqueb
NA Namibia
NO Norway
NZ New
Zealandb
OA African
Intellectual
Property
Organization
(OAPI)c
OM Oman
PH Philippinesh
PK Pakistanb
PL Poland
PT Portugal

RO Romania
RS Serbia
RU Russian
Federation
RW Rwanda
SD Sudan
SE Sweden
SG Singaporeb
SI Slovenia
SK Slovakia
SL Sierra Leone
SM San Marino
ST Sao Tome
and Principe
SX Sint Maarten
(Dutch part)f
SY Syrian Arab
Republic
SZ Eswatini
TH Thailand
TJ Tajikistan
TM Turkmenistan
TN Tunisia
TR Turkey
TT Trinidad and
Tobagob
UA Ukraine
US United States
of Americad
UZ Uzbekistan
VN Viet Nam
WS Samoa
ZM Zambia
ZW Zimbabwe

You can find information on the procedures in national or regional offices in the Member Profile Database,
available at www.wipo.int/madrid/memberprofiles.

MM4 (E) – March 2022

MM4 (E), page 3

a

The designation of the European Union covers its Member States (Austria, Belgium, Bulgaria, Croatia,
Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Ireland, Italy,
Latvia, Lithuania, Luxembourg, Malta, The Netherlands, Poland, Portugal, Romania, Slovakia, Slovenia,
Spain, Sweden).
If the European Union is designated, it is compulsory to indicate a second language before the Office of the
European Union. The second language must be chosen from among the following five languages, but may
not be the language of the international application from which the international registration indicated in item 1
resulted, regardless of the language of the present subsequent designation. Thus, for example, if the
international application was filed in French and this subsequent designation is in English, French may not
be selected as the second language (check one box only):
English

French

German

Italian

Spanish

Moreover, if the applicant wishes to claim the seniority of an earlier mark registered in, or for, a Member
State of the European Union, the official form MM17 must be annexed to the present subsequent
designation.
b

By designating Brunei Darussalam, Guernsey, India, Ireland, Lesotho, Malawi, Malaysia, Mozambique,
New Zealand, Pakistan, Singapore, Trinidad and Tobago or the United Kingdom, the holder declares
that he/she has the intention that the mark will be used by him/her or with his/her consent in that country in
connection with the goods and services identified in the present subsequent designation.

c

The designation of the African Intellectual Property Organization (OAPI) covers the following Member States:
Benin, Burkina Faso, Cameroon, Central African Republic, Chad, Comoros, Congo, Côte d’Ivoire, Equatorial
Guinea, Gabon, Guinea, Guinea-Bissau, Mali, Mauritania, Niger, Senegal, Togo.

d

If the United States of America is designated, it is compulsory to annex to the present international
application the official form (MM18) containing the declaration of intention to use the mark required by this
Contracting Party. Item 5(a) of the present form should also be completed.

e

Cuba, Brazil and Japan have made a notification under Rule 34(3)(a) of the Common Regulations. Their
respective individual fees are payable in two parts. Therefore, if Cuba, Brazil or Japan is designated,
only the first part of the applicable individual fee is payable at the time of filing the present international
application. The second part will have to be paid only if the Office of the Contracting Party concerned is satisfied
that the mark which is the subject of the international registration qualifies for protection. The date by which the
second part must be paid, and the amount due, will be notified to the holder of the international registration
at a later stage.

f

Territorial entity previously part of the former Netherlands Antilles.

g

Protection in BQ (Bonaire, Saint Eustatius and Saba) is granted automatically with the designation (see
Information Notice No. 27/2011).

h

Brazil, Estonia, India and the Philippines have made the declaration referred to in Article 14(5) of the
Protocol. Accordingly, it is not possible to subsequently designate Brazil in respect of international
registrations effected prior to October 2, 2019, Estonia in respect of international registrations effected prior
to November 18, 1998, India in respect of international registrations effected prior to July 8, 2013, and the
Philippines in respect of international registrations effected prior to July 25, 2012.

i

By designating Brazil, the holder declares that the holder, or a company controlled by the holder, effectively
and lawfully conducts business in connection with the goods and services for which Brazil is being
designated; and, agrees to receive notifications, including summons, not covered by the Madrid Protocol
concerning the international registration of the mark that is the subject of this subsequent designation, issued
in judicial proceedings held in Brazil, by post.

j

The designation of Benelux covers the following States: Belgium, Luxembourg and the Netherlands.

k

The designation of the United Kingdom covers England, Wales, Scotland, Northern Ireland, the British
Overseas Territory of the Falkland Islands (Malvinas) and Gibraltar, as well as the two British Crown
Dependencies of the Isle of Man and Jersey (see Information Notices No. 38/2015 and 77/2020).

l

The Bailiwick of Guernsey is a self-governing British Crown Dependency (see Information Notice
No. 77/2020).

MM4 (E) – March 2022

MM4 (E), page 4
4. GOODS AND SERVICES CONCERNED BY THE SUBSEQUENT DESIGNATION3
Check only one box.
(a)

the subsequent designation is made, in respect of all the Contracting Parties
designated in item 3, for all the goods and services listed in the international
registration indicated in item 1; or

(b)

the subsequent designation is made, in respect of all the Contracting Parties
designated in item 3, only for those goods and services listed in the continuation
sheet (which must be grouped in the appropriate class(es)); or:

(c)

the subsequent designation is only for those goods and services listed in the
continuation sheet in respect of the Contracting Parties identified in the said
continuation sheet; in respect of the other Contracting Parties designated in
item 3, the subsequent designation is for all the goods and services listed in the
international registration identified in item 14.

5. MISCELLANEOUS INDICATIONS
Only provide these indications or translations if they are not already recorded in the
International Register; if this is the case, the International Bureau will disregard any new
indication or translation provided in item 6 of this form.
(a)

Indications concerning the holder (as may be required by certain designated
Contracting Parties, such as, for example, the United States of America; only provide
indications in either item (i) or in item (ii) but not in both items):
(i)

If the holder is a natural person, nationality of the holder:
Nationality of the
holder:

(ii)

If the holder is a legal entity, provide both of the following indications:
Legal nature of the legal
entity:
State (country) and, where
applicable, territorial unit
within that State (canton,
province, state, etc.), under
the law of which the said
legal entity has been
organized:

3

You can use the Madrid Goods and Services Manager (MGS) to find indications accepted by WIPO. In MGS,
you can also find acceptance information for selected Contracting Parties. MGS is available at www.wipo.int/mgs.
4
Use font “Courier New” or “Times New Roman”, size 12 pt., or larger. Use semicolon (;) to separate
indications or goods or services listed in a given class. For example:
09
Screens for photoengraving; computers.
35
Advertising; compilation of statistics; commercial information agencies.

MM4 (E) – March 2022

MM4 (E), page 5
(b)

Indication, for each color, of the principal parts of the mark that are in that color
(as may be required by certain designated Contracting Parties):

(c)

Translation of the mark (as may be required by certain designated Contracting
Parties; do not check the box in item (d) if you provide a translation in this item):

(d)

(e)

(i)

into English:

(ii)

into French:

(iii)

into Spanish:

Check this box if the words contained in the mark have no meaning (and
therefore cannot be translated; do not check this box if you have provided a
translation in item (c)).
Voluntary description of the mark (any description of the mark by words, including
the description contained in the basic application or registration, if you were not
required to provide this description in item 9(e)(i) of the international application form
MM2):

MM4 (E) – March 2022

MM4 (E), page 6
6. DATE OF THE SUBSEQUENT DESIGNATION5
Check only one box.
(a)

this subsequent designation shall take effect after the renewal of the
international registration indicated in item 1;

(b)

this subsequent designation shall take effect after the recording in the
International Register of the following change or cancellation in respect of
the international registration indicated in item 1 (specify the change or
cancellation):

7. SIGNATURE OF THE HOLDER AND/OR THEIR REPRESENTATIVE
Holder (as recorded in the International Register):
By signing this form, I declare that I am entitled to sign it under the applicable law.
Name:
Signature:

Representative of the holder (as recorded in the International Register):
By signing this form, I declare that I am entitled to sign it under the applicable law.
Name:
Signature:

5

If neither of these boxes is checked, the date of this subsequent designation will, subject to Rule 24(6)(c)(i) of
the Regulations under the Protocol, be the date of its receipt by the International Bureau if it has been presented
direct to the International Bureau, or, if it has been presented through the intermediary of an Office, the date of
receipt by that Office, provided that the said designation has been received by the International Bureau within a
period of two months from that date and subject to Rule 24(6)(c)(i) and (d) of the Regulations under the Protocol.

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MM4 (E), page 7
8. DATE OF RECEIPT AND DECLARATION BY THE OFFICE OF THE CONTRACTING
PARTY OF THE HOLDER PRESENTING THE SUBSEQUENT DESIGNATION
Where the subsequent designation is presented through an Office.
Date of receipt of the subsequent
designation by the Office (dd/mm/yyyy)
9. SIGNATURE OF THE OFFICE PRESENTING THE REQUEST
If applicable.
(a)

Name of the Office:

(b)

Name and signature of the official signing on behalf of the Office:
By signing this form, I declare that I am entitled to sign it under the applicable law.

(c)

E-mail address of the contact person in the Office:

MM4 (E) – March 2022

MM4 (E), page 8
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 (see Fee Calculator: www.wipo.int/madrid/en/fees/calculator.jsp)

Basic fee (Swiss francs)

300.-

Complementary fees:
Number of designations for
which complementary fee is
applicable

Complementary
fee
x 100 Swiss
francs

Total amount of the
complementary fees
=

=

Designated Contracting
Parties

Individual fee

Individual fees (Swiss francs)6:
Designated Contracting
Parties

Individual fee

Total individual fees =
GRAND TOTAL (Swiss francs) =

6

Where individual fees have been declared, you will pay these fees instead of the standard fees except where
the designated Contracting Party and the Contracting Party of the holder are both States bound by the Protocol and
the Agreement, in which case, a complementary fee is payable.

MM4 (E) – March 2022

MM4 (E), page 9
(c)

METHOD OF PAYMENT

Identity of the party effecting the
payment:
Payment received and acknowledged
by WIPO

WIPO receipt number

Payment made to WIPO bank account
IBAN No. CH51 0483 5048 7080 8100 0
Crédit Suisse, CH-1211 Geneva 70
Swift/BIC: CRESCHZZ80A

Payment identification

dd/mm/yyyy

Payment made to WIPO postal account
(within Europe only)
IBAN No. CH03 0900 0000 1200 5000 8
Swift/BIC: POFICHBE

Payment identification

dd/mm/yyyy

MM4 (E) – March 2022

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MM4 (E) – March 2022

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File TitleMM4(E)
File Modified2022-03-01
File Created2014-07-21

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