Form 3 – Petition for Grant of a Patent

Instructions

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In section 1, subsection 3(2) and sections 5 and 6, names and addresses must be presented in the following order with a clearly visible separation between the various elements: family name (in capital letters), given name(s), initials, or firm name, street name and number, city, province or state, postal code, telephone number, fax number and country.

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Form 3

(Subsection 27 (2) of the Patent Act)

• 1. The applicant, , whose complete address is , requests the grant of a patent for an invention, entitled , which is described and claimed in the accompanying specification.
• Select if section 2 does not apply
• 2. This application is a division of application number , filed in Canada on .
• Select if section 3 will be submitted in a separate document.
• 3. (1) The applicant is the sole inventor.
• 3. (2) The inventor is , whose complete address is and the applicant is the legal representative of the inventor.
• Select if section 4 does not apply or will be submitted in a separate document
• 4. The applicant requests priority in respect of the application on the basis of the following previously regularly filed application:
  Country of filing

  Application Number

  Filing date

  Country of filing

  Application Number

  Filing date
• Select if section 5 does not apply or will be submitted in a separate document
• 5. The applicant appoints , whose complete address in Canada is , as the applicant's representative in Canada, pursuant to section 29 of the Patent Act.
• Select if section 6 does not apply or will be submitted in a separate document
• 6. The applicant appoints , whose complete address is , as the applicant's patent agent.
• 7. The applicant believes that in accordance with the Patent Rules they are entitled to pay fees at the small entity level in respect of this application and in respect of any patent issued on the basis of this application.
• Select if section 8 does not apply
• 8. The applicant requests that Figure No. of the drawings accompany the abstract when it is open to public inspection under section 10 of the Patent Act or published.