REPUBLIC OF PANAMA

(21) Application No. (22) Date and time

(LETTERHEAD OF THE MINISTRY OF COMMERCE AND
INDUSTRIES, INDUSTRIAL PROPERTY REGISTRATION
OFFICE)

TRADEMARK APPLICATION FOR REGISTRATION

TYPE OF MARK:
TRADEMARK SERVICE MARK COLLECTIVE MARK SINGLE CLASS
ADVERTISING EXPRESSION TRADE NAME AND GUARANTEE MARK MULTICLASS
OR SIGN ASSOCIATIONS

DISTINCTIVE SIGN:
WORD FIGURATIVE COMBINED SMELL SOUND THREE-DIMENSIONAL
IDENTIFICATION: NATURAL PERSON LEGAL PERSON
(73) NAME OF APPLICANT, ID CARD, ADDRESS, JURISDICTION AND REGISTRATION DATA: CODE:

NON-RESIDENT APPLICANTS, SUBMIT AN ADDRESS IN THE REPUBLIC OF PANAMA FOR SERVICE

PURPOSES OF THIS TRADEMARK:

(74) LEGAL REPRESENTATIVE AND GENERAL DATA (INCLUDE E-MAIL) FOR THIS CODE:

TRADEMARK:

TRADEMARK OR NAME REQUESTED: No. of Power

of Attorney

(57) PRODUCTS OR SERVICES: INSERT AN X IN CHECKBOX

01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23

24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 0

SPECIFY GOODS AND/OR SERVICES FOR CLASS:

SPECIFY GOODS AND/OR SERVICES FOR CLASS:

SPECIFY GOODS AND/OR SERVICES FOR CLASS:

SPECIFY GOODS AND/OR SERVICES FOR CLASS:

 2

NUMBER OF ENCLOSURES FOR GOODS

AND/OR SERVICES TO BE PROTECTED: LABEL (Max. 7 x 7 cm.)

OTHER LEGAL REMARKS:

-

. ACTIVITY COVERED BY THE TRADE NAME:

TYPE OF FIGURATIVE ELEMENT: DIVISION:

CATEGORY: SECTION:
CLAIMED PRIORITY:
COUNTRY:
APPLICATION NO.:
DATE:
I CERTIFY THAT THE ABOVE INFORMATION
POWER OF ATTORNEY CONFORMS TO THE PROVISIONS OF THE LAWS
REGULATING INDUSTRIAL PROPERTY.
SURETY BOND

SWORN STATEMENT OF USE

NAME:
LABELS

PRIORITY DOCUMENT ID NO.:

USE REGULATIONS

LETTER OF CONSENT
SIGNATURE:
PAYMENT RECEIPT FOR 10 YEARS
PAYMENT RECEIPT OF CORPORATION TAX
AND SURCHARGE PANAMA,

OTHER