Form WIPO DM/1/IV WIPO DM/1/IV Annex IV - Reduction of individual designation fee)

International Design Applications (Hague Agreement)

WIPO DM.1.IV - Annex IV

Reduction of United States Individual Designation Fee

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 Annex is only relevant for the designation of the United States of America and is mandatory content if
the applicant claims micro entity status in form DM/1. It cannot be submitted separately.

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

For use by WIPO
Document type: DDE
Contracting Party: US

Reduction of Individual Designation Fees
Number of pages (including this cover page):

January 2022


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