FORM 11, PATENTS ACT 1983 (MALAYSIA

FORM 11, PATENTS ACT 1983 (MALAYSIA)
APPLICATION FOR COMPULSORY LICENCE
(PATENTS REGULATIONS 1996 – REGULATION 38)
Patents Form No 11
PATENTS ACT 1983
APPLICATION FOR
COMPULSORY LICENCE
(REGULATION 38)
To : The Registrar of Patents
Patent Registration Office
Kuala Lumpur
Malaysia
Please submit one copy of this Form
together with the prescribed fee.
For Official Use
APPLICATION NO : …………………….....
Filing Date : ………………………...............
Application received on : ……………………
Fee received on : ………………………........
Amount : ………………………………........
* Cheque/Postal Order/Money Order/Draft/Cash
No : ………....................................................
Date of mailing : …………………………....
Applicant’s or Agent’s file reference
………………............................................................
I. IN THE MATTER OF:
Patent Application No: ……………….........Filing Date: ...…………………………
II. APPLICANT:
Name : …………………………………………………………………...
Address:....………………………………………..........................................
…………..……………………………………………………………….....
Address for service in Malaysia: ………………………………………….
………………………………………………………………………..........
Nationality: ………………………………………………………………..
* Permanent residence or principal place of business: ……………………
………………………………………………………………………..........
Telephone Number Fax Number
(if any) (if any)
…………………………………... .................................................

Results (Indonesian) 1:

FORM 11, PATENTS ACT 1983 (MALAYSIA)APPLICATION FOR COMPULSORY LICENCE(PATENTS REGULATIONS 1996 – REGULATION 38)Patents Form No 11PATENTS ACT 1983APPLICATION FORCOMPULSORY LICENCE(REGULATION 38)To : The Registrar of PatentsPatent Registration OfficeKuala LumpurMalaysiaPlease submit one copy of this Formtogether with the prescribed fee.For Official UseAPPLICATION NO : …………………….....Filing Date : ………………………...............Application received on : ……………………Fee received on : ………………………........Amount : ………………………………........* Cheque/Postal Order/Money Order/Draft/CashNo : ………....................................................Date of mailing : …………………………....Applicant’s or Agent’s file reference………………............................................................I. IN THE MATTER OF:Patent Application No: ……………….........Filing Date: ...…………………………II. APPLICANT:Name : …………………………………………………………………...Address:....………………………………………..........................................…………..……………………………………………………………….....Address for service in Malaysia: ………………………………………….………………………………………………………………………..........Kebangsaan:...* Tetap tinggal atau tempat usaha utama:...………………………………………………………………………..........Nomor Faks nomor telepon(jika ada) (jika ada)…………………………………... .................................................