Patents Act 1953 Application for patent [To be accompanied by two copies of either a provisional specification (patents form 4) or a complete specification (patents form 5)] NOTE.—This is a comprehensive form and parts inappropriate to a particular application should be cancelled. In the case of an application by the inventor, only sections 1, 4, and 6 of this form are appropriate, and section 5 if a patent of addition is applied for. 1. I (or We), [Insert (in full) name, address, and nationality of applicant(s)], am (or are) in possession of an invention which is described in the accompanying provisional (or complete) specification under the title [Insert title of invention]. I, (or We or The said) [Insert name of inventor if inventor is the applicant] claim(s) to be the true and first inventor(s) of the invention. Or,— 2. I (or We) believe [Insert (in full) name, address, and nationality of inventor(s) if inventor is not the applicant] to be the true and first inventor of the invention, and I (or we or the said) am (or are or is) the assignee(s) of the said inventor(s) in respect of the right to make this application (or personal representative(s) of the said inventor(s)). 3. The invention or a part of the invention was communicated from abroad to me (or us or the said) ........... by [Insert (in full) name address, and nationality of communicator]. 4. I (or We) declare that to the best of my (or our) knowledge and belief the statements made above are correct and there is no lawful ground of objection to the grant of a patent to me (or us) on this application, and I (or we) pray that a patent may be granted to me (or us) for the said invention. [Use of the invention in New Zealand before the date of the application for a patent may be a lawful ground of objection.] 5. And I (or we) request that the patent may be granted as a patent of addition to patent No ....... (or the patent to be granted on application No........ ). 6. And I (or we) request that all notices, requisitions, and communications relating to this application may be sent to ............ at [The address must be within New Zealand], who is (or are) hereby appointed to act for me (or us). [To be signed by applicant(s).] To the Commissioner, The Patent Office, Wellington C 1.

Patents Act 1953 Convention application for a patent [To be accompanied by two copies of complete specification (patents form 5)] NOTE.—This is a comprehensive form, and parts inappropriate to a particular application should be cancelled. 1. I (or We), [Insert (in full) name, address, and nationality of applicant(s)], hereby declare that an application (or applications) for protection for an invention or inventions has (or have) been made in the following country or countries and on the following official date or dates, namely: In [Insert the name of the convention country in which the first application was made] on [Insert the official date of the first application in a convention country.] by [Insert name of applicant and (if inventor is not the applicant) address and nationality. Particulars of any further applications should be given on the back of this form or on a separate sheet]: In, etc. In, etc. and that the said application or each of the said applications was the first application in a convention country in respect of the relevant invention by me (or us) or by any person from whom I (or we) derive title. 2. I am (or we are) the assignee(s) of the said [Insert name of applicant and (if inventor is not the applicant) address and nationality. Particulars of any further applications should be given on the back of this form or on a separate sheet] by virtue of [Give particulars of the assignment] or the personal representative(s) of the said [Insert name of application and (if inventor is not the applicant) address and nationality. Particulars of any further applications should be given on the back of this form or on a separate sheet]. 3. I (or We) declare that to the best of my (or our) knowledge and belief there is no lawful ground of objection to the grant of a patent to me (or us) on this application, and pursuant to subsection (2) (and subsection (3)) of section 7 of the Patents Act 1953 I (or we) pray that a patent may be granted to me (or us) with priority founded on the above-mentioned application(s) in a convention country or countries as provided by subsection (4) of section 11 of that Act for the invention described in the accompanying complete specification under the title............. 4. And I (or we) request that the patent may be granted as a patent of addition to patent No...... (or the patent to be granted on application No......). 5. And I (or we) request that all notices, requisitions, and communications relating to this application may be sent to .......... at [The address must be within New Zealand] who is (or are) hereby appointed to act for me (or us).

[To be signed by applicant(s).] To the Commissioner The Patent Office, Wellington C 1.

Patents Act 1953 Application for the grant of a patent of addition instead of an independent patent I (or We), [State full name, address, and nationality of patentee or patentees], hereby request that patent No..... of which I am (or we are) the patentee(s) be revoked and that instead thereof a patent of addition to patent No........ of which I am (or we are) also the patentee be granted to me (or us), such patent of addition to bear the same date as the patent so revoked. [To be signed by the patentee.] To the Commissioner, The Patent Office Wellington C 1

Patents Act 1953 Provisional specification (To be furnished in duplicate) [Insert title agreeing with that in the application form.] I (or WE), [State (in full) name, address, and nationality of applicant or applicants as in application form], do hereby declare this invention to be described in the following statement: [Here begin description of the invention. The continuation of the specification should be upon paper of the same size as this form on one side only, with the lines well spaced and with a margin of [2.5 cm] on the left hand part of the paper. The specification and the duplicate thereof must be signed at the end].

Patents Act 1953 [Where priority as provided by subsection (2) or subsection (3) of section 11 of the Patents Act 1953 is desired in respect of one or more provisional specifications, quote number or numbers and date or dates.] No ............... Date :.................. COMPLETE SPECIFICATION (To be furnished in duplicate) [Insert title of invention.] I (or WE), [State (in full) name, address, and nationality of applicant or applicants as in application form], hereby declare the invention, for which I (or we) pray that a patent may be granted to me (or us), and the method by which it is to be performed, to be particularly described in and by the following statement: [Here begin full description of invention. The continuation of the specification should be upon paper of the same size as this form, on one side only, with the lines well spaced and with a margin of [2.5 cm] on the left hand part of the paper. The completion of the description should be followed by the words What I (or we) claim is after which should be written the claim or claims numbered consecutively. (See note below.) The specification and the duplicate thereof must be signed at the end]. NOTE.—The claims must relate to a single invention, must be clear and succinct, and must be fairly based on the matter disclosed in the specification. They should form in brief a clear statement of that which constitutes the invention. Applicants should be careful that their claims include neither more nor less than they desire to protect by their patent. Any unnecessary multiplicity of claims or prolixity of language should be avoided. Claims should not be made for the efficiency or advantages of the invention.

Patents Act 1953 Declaration as to inventorship [section 10(5)] I (or WE) [Insert name(s) of applicant(s)], hereby declare that the true and first inventor(s) of the invention disclosed in the complete specification filed in pursuance of my (or our) application(s) numbered ........... and dated the ....... day of ........... 19 ...... is (or are): [State name, address, and nationality of inventor or of each inventor] and that my (or our) right to apply for a patent for the invention is as follows: [This need not be filled in if the inventor(s) named above is or are an applicant or applicants, or if the right to apply is as stated on the application form]. [To be signed by applicant(s).] To the Commissioner, The Patent Office, Wellington C 1.

Patents Act 1953 Application for extension of time for filing a complete specification I (or WE) hereby, in respect of application No ..........., dated ..........., request an extension of time until ................ in which to file a complete specification . [To be signed by applicant or applicants, or his or their agent.] To the Commissioner, The Patent Office, Wellington C 1.

Patents Act 1953 Request for the post-dating of an application under section 12(3) I (or WE) hereby request that application No......................, filed on the day of 19....., be deemed to have been made on the following date, namely, the ..................... day of ................... 19..... [To be signed by applicant(s).] To the Commissioner, The Patent Office, Wellington C 1.

Patents Act 1953 Request under regulation 38 for advancement of examination I (or WE) hereby request that application No ..................., filed on the day of 19 ....., be advanced for examination and investigation on the following grounds: [Here set out grounds in full and verify by accompanying statutory declaration or other evidence to the satisfaction of the Commissioner]. [To be signed by applicant(s) or his or their agent.] To the Commissioner, The Patents Office, Wellington C 1.

Patents Act 1953 Application for extension of time under regulation 40(5), 41, 44, 58, or 59

Patents Act 1953 Application under section 91(2) for the result of a search made under sections 13 and 14, or for information furnished under section 15(b)(i)

Patents Act 1953 Application under section 16(2) for deletion of reference I (or WE), [State (in full) name and address of applicant(s)] hereby apply for deletion of the reference to patent No............ which has been inserted in the complete specification of my (or our) (application for a) [Delete the words in parentheses if a patent has been granted] patent No ................. in pursuance of a direction under section 16(1) of the Patents Act 1953. The facts relied upon in support of this application are [The facts must be stated fully]. Communications should be sent to ..................... at [The address must be within New Zealand], who is (or are) hereby appointed to act for me (or us). [To be signed by applicant(s) or his or their authorized agent.] To the Commissioner, The Patent Office, Wellington C 1

Patents Act 1953 Notice of desire for extension of the period for putting an application in order I (or WE) hereby give notice that I (or we) desire the period for putting in order application No ...... dated to be extended to .......... months from the date of filing of the complete specification. [To be signed by applicant or applicants or his or their agent.] To the Commissioner, The Patent Office, Wellington C 1.

Patents Act 1953 Request for postponement of acceptance of complete specification [section 20(1)] I (or WE) hereby request a postponement of the acceptance of the complete specification of application No ............ dated ................ to a date not later than the expiration of .............. months from the date of filing of the complete specification. [To be signed by applicant or applicants or his or their agent.] To the Commissioner, The Patent Office, Wellington C 1.

Patents Act 1953 Notice of opposition to grant of patent (section 21) (To be accompanied by copy, and a statement of case in duplicate) I (or WE), [State full name and address], hereby give notice of opposition to the grant of a patent upon application No ........... applied for by .................. upon the ground [State upon which of the grounds of opposition permitted by section 21 of the Patents Act 1953 the grant is opposed, and identify all specifications and other publications relied upon]. Communications should be sent to .................... at [The address must be within New Zealand], who is (or are) hereby appointed to act for me (or us). [To be signed by opponent(s).] To the Commissioner, The Patent Office, Wellington C 1.

Patents Act 1953 Application under section 21 (2) (proviso) for an extension of the period for giving notice of opposition I (or WE), [State name and address], hereby apply for one month's extension of the period for giving notice of opposition to the grant of letters patent in respect of application No ................. The circumstances in and grounds upon which this extension is applied for are as follows: [The circumstances and grounds must be stated in detail]. Communications should be sent to .................... at [The address must be within New Zealand]. Signature:........................ To the Commissioner, The Patent Office, Wellington C 1.

Patents Act 1953 Notice that hearing before the Commissioner will be attended I (or We), [State name and address], hereby give notice that the hearing fixed for the [Insert date of hearing] in reference to [Give particulars (ie, number of application or patent, names of parties and nature of proceedings)] will be attended by myself (or ourselves) or by some person on my (or our) behalf. Signature:.................... To the Commissioner, The Patent Office Wellington C 1.

Patents Act 1953 Request under section 23(3) I (or WE), [State (in full) name, address, and nationality of applicant or applicants for the patent], who made application No ........ on the ............. 19...... for the grant of a patent for an invention the title of which is [Insert title of invention] and I (or We), [State the name, address, and nationality of the deviser or devisers if inventor is not the applicant], hereby declare that the said [Insert name of deviser or devisers] is (or are) the inventor(s) in the sense of being the actual deviser(s) of (a substantial part of) the invention, and that the application for the patent is a direct consequence of his (or their) being such inventor(s), and we hereby request that the said [Insert name of deviser or devisers] be mentioned as such inventor(s) in accordance with section 23 of the Patents Act 1953. A statement setting out the circumstances upon which we rely to justify this request is attached. Communications should be sent to ........... at [The address must be within New Zealand], who is (or are) hereby appointed to act for us. [To be signed by all the persons making the request.] To the Commissioner, The Patent Office, Wellington C 1.

Patents Act 1953 Claim under section 23(4) (To be accompanied by copy or copies as required by regulation 61 of the Patents Regulations 1954) I [(State in full) name address, and nationality of the claimant], hereby declare that I am the inventor in the sense of being the actual deviser of (a substantial part of) the invention entitled [Insert title of invention] in respect of which application No ......... for a patent was made by [Insert name and address of applicant or applicants for the patent] on the ............ 19...., and that the application for the patent is a direct consequence of my being such inventor, and I hereby claim to be mentioned as such inventor in accordance with section 23(4) of the Patents Act 1953. A statement setting out the circumstances upon which I rely to justify this claim is attached together with a copy (or copies) thereof as required by regulation 61 of the Patents Regulations 1954. Communications should be sent to ............. at [The address must be within New Zealand], who is (or are) hereby appointed to act for me. [To be signed by the claimant.] To the Commissioner, The Patent Office, Wellington C 1.

Patents Act 1953 Application under section 23(5) I (or We) [State (in full) name, address, and nationality of the person or persons making this application], hereby apply for an extension of time (not exceeding one month) for making a request under section 23(3) of the Patents Act 1953 (or a claim under section 23 (4) of the Patents Act 1953)in respect of application No....... for a patent made by [Insert name, address, and nationality of applicant or applicants for the patent] on the .................. 19...... in respect of an invention the title of which is [Insert title of the invention]. Communications should be sent to ............. at [The address must be within New Zealand]. [To be signed by the person or all the persons making the application or by his or their duly authorized agent.] To the Commissioner, The Patent Office, Wellington C 1.

Patents Act 1953 Application under section 23(8) (To be accompanied by copies as required by regulation 63 of the Patents Regulations 1954) I (or We), [State (in full) name, address, and nationality of the person or persons making this application], hereby declare that [Insert the name of the person mentioned as the actual deviser] ought not to have been mentioned under section 23 of the Patents Act 1953 as the inventor in the sense of being the actual deviser of (a substantial part of) the invention covered by application No ........... dated the .............. 19...., and entitled [Insert title of invention], and I (or we) hereby apply for a certificate to that effect. A statement setting out the circumstances upon which I (or we) rely to justify this application is attached together with copies thereof as required by regulation 63 of the Patents Regulations 1954. Communications should be sent to .............. at [The address must be within New Zealand], who is (or are) hereby appointed to act for me (or us). [To be signed by all the persons making the application.] To the Commissioner The Patent Office, Wellington C 1.

Patents Act 1953 Claim under section 24(1) to proceed as an applicant or co-applicant I (or We) [State name of claimant(s)] hereby request that the patent application No [State the number and date of the application for patent] dated ......... made by [State name of the applicant or applicants for patent] may proceed in the name(s) of [Insert (in full) name, address, and nationality of the person or persons in whose name(s) it is requested that the application shall proceed]. I (or We) claim to be entitled to proceed as applicant(s) for the patent by virtue of [Give the particulars of the document, giving its date and the parties thereto, and showing how the claim here made is substantiated]. And in proof whereof I (or We) transmit the accompanying [State the nature of the document. The certified copy should be written, typewritten, or printed on [A4 international standard size] paper]. My (or Our) address for service in New Zealand is ............. [To be signed by claimant(s).] I (or We) [To be signed by the applicant(s)] consent to the above request. To the Commissioner, The Patent Office, Wellington C 1.

Patents Act 1953 Application for directions under section 24(5) as to proceeding with an application for a patent in case of dispute between joint applicants (To be accompanied by a statement of case and by copies of the application and statement as required by regulation 66 of the Patents Regulations 1954) I, [State name and address], being a joint applicant with [State name and address of other applicant(s)] in the application for a patent numbered .............., hereby declare that a dispute has arisen between us and request that an order of the Commissioner be made giving directions for enabling that application to proceed. Particulars of the matters in dispute arc given in the annexed statement setting out the facts upon which I rely, and the relief which I seek. Communications should be sent to .................. at [The address must be within New Zealand], who is hereby appointed to act for me. Signature:............. To the Commissioner, The Patent Office, Wellington C 1.

Patents Act 1953 Request for the sealing of a patent I(or WE), [State name of applicant or applicants], request that a patent may be sealed on my (or our) application No .......... and that the following may be entered on the register as my (or our) address for service: Signature:................. To the Commissioner, The Patent Office, Wellington C 1.

Patents Act 1953 Application under section 27(3) for extension of the period for making a request for the sealing of a patent I (or WE) hereby apply for ............. month(s) ................ extension of the period for making a request for the sealing of a patent upon application No .......... Signature:................... To the Commissioner, The Patent Office, Wellington C 1.

Patents Act 1953 Application under section 27(4) for an extension of the period for making a request for the sealing of a patent

Patents Act 1953 Application under section 28 for amendment of letters patent (To be accompanied by evidence verifying the statements made in this application) I (or WE), [State name and address], hereby request that letters patent No ............ granted to .................. may be amended by substituting the name of [State name, address and nationality of person to whom patent should have been granted] for the name of the grantee. My (or Our) address for service in New Zealand is ............... Signature: .............. To the Commissioner, The Patent Office, Wellington C 1.

Patents Act 1953 Payment of renewal fee I (or WE), [State name of person tendering the fee], hereby transmit the fee prescribed for the continuation in force of [Here insert name of patentee(s)] patent No .......... for a further period of .......... and request that the certificate of payment may be sent to me (or us) at [Here insert full address]. Signature: ................ NOTE.—If the address given above is not that entered in the register of patents as the patentee's address for service and it is desired to amend the entry in the register, application therefor must be made on patents form 62. To the Commissioner, The Patent Office, Wellington C 1.

Patents Act 1953 Request for extension of the period for payment of renewal fee I (or WE) hereby apply for an extension of ............... months(s) of the period prescribed for payment of the renewal fee of .................. upon my (or our) patent No ..................... [State name and full address to which receipt is to be sent.] Signature:...................... To the Commissioner, The Patent Office, Wellington C 1.

Patents Act 1953 Certificate of payment of renewal fee Letters Patent No ............. This is to certify that ................. did this ............ day of .......... 19 ..... make the prescribed payment of £........ in respect of a period of ............. from .............. Commissioner of Patents. The Patent Office, Wellington C 1.

Patents Act 1953 Application under section 31, section 32, or section 33 for extension of term of patent (To be accompanied by evidence in support of the application) I (or WE), [State (in full) name, address, and nationality of applicant or applicants], hereby apply for extension of the term of patent No ........... for [Insert period for which extension is sought]. Communications should be sent to ............ at ......... [The address must be within New Zealand, who is (or are) hereby appointed to act or me (or us). [To be signed by the applicant or applicants.] To the Commissioner, The Patent Office, Wellington C 1.

Patents Act 1953 Notice of opposition to application or extension of term of patent (To be accompanied by a copy, and evidence (in duplicate) in support of the opposition) I (or WE), [State (in full) name, address, and nationality of opponent or opponents], hereby give notice of opposition to the application for extension of the term of patent No ........... Communications should be sent to ........... at [The address must be within New Zealand] who is (or are) hereby appointed to act for me (or us). [To be signed by the opponent or opponents.] To the Commissioner, The Patent Office, Wellington C 1.

Patents Act 1953 Application under section 35 for the restoration of a patent (To be accompanied by evidence verifying the statements made in this application) I (or WE), [State name and address], hereby apply for an order for the restoration of patent No ........... The circumstances which led to the failure to pay the renewal fee of [State amount of fee] on or before the [State date when fee was due] are as follows: [The circumstances must be stated in detail]. Communications should be sent to .......... at [The address must be within New Zealand], who is (or are) hereby appointed to act for me (or us). [To be signed by applicant.] To the Commissioner, The Patent Office, Wellington C 1.

Patents Act 1953 Notice of opposition to an application under section 35 for the restoration of a patent (To be accompanied by a copy, and a statement of case in duplicate) I (or We), [State name and address], hereby give notice of opposition to the application for restoration of patent No ......... for the following reason: ............................ Communications should be sent to ............ at [The address must be within New Zealand], who is (or are) hereby appointed to act for me (or us). Signature of opponent: ................... To the Commissioner, The Patent Office, Wellington C 1.

Patents Act 1953 Additional fee on an application under section 35 for restoration of a patent I (or WE), [State name and address], the applicant(s) for the restoration of patent No ........, hereby transmit the prescribed additional fee, together with a memorandum in form 28 in respect of the unpaid renewal fee(s). Signature of applicant(s): ................ To the Commissioner, The Patent Office, Wellington C 1.

Patents Act 1953 Application under section 36 for the sealing of a patent (To be accompanied by evidence verifying the statements made in this application) I (or WE), [State name and address], the applicant(s) for a patent numbered ..........., hereby apply for an order for a patent to be sealed thereon. The circumstances which led to the failure to make the prescribed request for sealing on or before the [State date when request was due] are as follows: [the circumstances must be stated in detail]. Communications should be sent to ............. at [The address must be within New Zealand], who is (or are) hereby appointed to act for me (or us). Signature: ................... To the Commissioner, The Patent Office, Wellington C 1.

Patents Act 1953 Notice of opposition to an application under section 36 for the sealing of a patent (To be accompanied by a copy, and a statement of case in duplicate) I (or WE), [State name and address], hereby give notice of opposition to the application for the sealing of a patent on application No .......... for the following reasons: ................. Communications should be sent to ........... at [The address must be within New Zealand], who is (or are) hereby appointed to act for me (or us). Signature: ................. To the Commissioner, The Patent Office, Wellington C 1.

Patents Act 1953 Additional fee on an application under section 36 for the sealing of a patent I (or WE), [State name and address], the applicant(s) for the sealing of a patent on application No ........, hereby transmit the prescribed additional fee together with a request in form 24 bearing the fee prescribed in respect of the making of the request for sealing. Signature of applicants for sealing: .................... To the Commissioner, The Patent Office, Wellington C 1.

Patents Act 1953 Application under section 37 for restoration of an application (To be accompanied by evidence verifying the statements made in this application) I (or WE), [State name and address], the applicant(s) for a patent numbered ........, hereby apply for an order of the Commissioner restoring the application and extending the period for complying with the requirements imposed on me (or us) by or under the Patents Act 1953 to the ............... day of ............ 19..... The circumstances which led to the failure to comply with the requirements imposed on me (or us) under that Act are as follows: [The circumstances must be stated in detail]. Communications should be sent to .............. at [The address must be within New Zealand], who is (or are) hereby appointed to act for me (or us). Signature: ................... To the Commissioner, The Patent Office, Wellington C 1.

Patents Act 1953 Notice of opposition to an application under section 37 for restoration of an application (To be accompanied by a copy, and a statement of case in duplicate) I (or WE), [State name and address] hereby give notice of opposition to the application for restoration of the application for a patent numbered .............. for the following reasons: .............. Communications should be sent to ............. at [The address must be within New Zealand], who is (or are) hereby appointed to act for me (or us). Signature: ................... To the Commissioner, The Patent Office, Wellington C 1.

Patents Act 1953 Application under section 38 for amendment of a complete specification after acceptance I (or WE), [State full name and address of applicant or patentee], seek leave to amend the complete specification No ............. as shown in red ink in the copy of the printed specification hereunto annexed. I (or We) declare that no action for infringement or proceeding before the Court for revocation of the patent is pending. [These words are to be struck out when a patent has not been sealed.] My (or Our) reasons for making this amendment are in detail as follows: [State full particulars of the reasons for seeking amendment. If this space is not sufficient the particulars may be continued on a separate sheet]. Communications should be sent to ................ at [The address must be within New Zealand], who is (or are) hereby appointed to act for me (or us). [To be signed by applicant or patentee.] To the Commissioner, The Patent Office, Wellington C 1.

Patents Act 1953 Notice of opposition to amendment of specification under section 38 (To be accompanied by a copy, and a statement of case in duplicate) I (or WE), [State full name and address], hereby give notice of opposition to the proposed amendment of specification No ......... for the following reason: ............... Communications should be sent to .............. at [The address must be within New Zealand], who is (or are) hereby appointed to act for me (or us). [To be signed by the opponent.] To the Commissioner, The Patent Office, Wellington C 1.

Patents Act 1953 Application for amendment of a complete specification not yet accepted I (or WE), [State (in full) name and address of applicant or applicants], seek leave to amend the specification of application No .............. of .................. as shown in red ink in the copy of the original specification hereunto annexed. My (or Our) reasons for making this amendment are as follows: [State reasons for seeking amendment]. [To be signed by applicant or applicants, or his or their agent.] To the Commissioner, The Patent Office, Wellington C 1.

Patents Act 1953 Application for amendment of an application for a patent I (or WE), [State full name and address of applicant or applicants], seek leave to amend my (or our) application No ............ of ........... as shown in red ink in the copy the original application hereunto annexed. My (or Our) reasons for making this amendment are as follows: [State reasons for seeking amendment]. [To be signed by applicant or applicants.] To the Commissioner, The Patent Office, Wellington C 1.

Patents Act 1953 Application under section 42 for the revocation of a patent (To be accompanied by a copy, and a statement of case in duplicate) I (or WE), [State full name and address], hereby apply for an order for the revocation of patent No .................. on the following grounds: [The ground or grounds of the application can only be one or more of the grounds on which the grant of the patent could have been opposed under section 21.] I (or We) declare that no action for infringement or proceeding in any Court for the revocation of the patent is pending. [If such action or proceeding is pending in any Court the application cannot be made without the leave of the Court.] Communications should be sent to .................. at [The address must be within New Zealand, who is (or are) hereby appointed to act for me (or us). [To be signed by applicant.] To the Commissioner, The Patent Office, Wellington C 1.

Patents Act 1953 Offer under section 43 to surrender a patent I (or WE), [State full name and address] hereby offer to surrender patent No ............ I (or We) declare that no action for infringement or proceeding in any Court for the revocation of the patent is pending. [Delete if any action or proceeding is pending, and furnish full particulars of the action or proceeding.] My (or Our) reasons for making this offer are as follows: .............. Communications should be sent to .................. at [The address must be within New Zealand], who is (or are) hereby appointed to act for me (or us). [To be signed by the patentee.] To the Commissioner, The Patent Office, Wellington C 1.

Patents Act 1953 Notice of opposition under section 43 to offer to surrender a patent (To be accompanied by a copy, and a statement of case in duplicate) I (or WE), [State full name and address], hereby give notice of opposition to the offer to surrender patent No .......... for the following reason:.................. Communications should be sent to ............. at [The address must be within New Zealand], who is (or are) hereby appointed to act for me (or us). [To be signed by the opponent.] To the Commissioner, The Patent Office, Wellington C 1.

Patents Act 1953 Voluntary application for endorsement of patent licences of right (To be accompanied by evidence verifying the statement in the application and by the letters patent) I (or WE), [State name and address], hereby request that patent No .......... may be endorsed Licences of right. I am (or We are) not precluded by contract from granting licences under the patent. Communications should be sent to ............ at [The address must be within New Zealand], who is (or are) hereby appointed to act for me (or us). [To be signed by the patentee.] To the Commissioner, The Patent Office, Wellington C 1.

Patents Act 1953 Application under section 44(2) for settlement of terms of licence under patent endorsed licences of right (To be accompanied by a copy, and a statement of case in duplicate)

Patents Act 1953 Application under section 45(1) by patentee for cancellation of endorsement of a patent licences of right (To be accompanied by evidence in support of the application)

Patents Act 1953 Application under section 45(2) by any person interested for cancellation of endorsement of patent licences of right (To be accompanied by a copy, and a statement of case in duplicate) I (or WE), [State name and address], hereby claim that the endorsement of patent No .............. Licences of right is and was at the time of the endorsement contrary to a contract in which I am (or we are) interested and I (or we) request that the endorsement may be cancelled. Communications should be sent to ............... at [The address must be within New Zealand], who is (or are) hereby appointed to act for me (or us). [To be signed by the applicant(s).] To the Commissioner, The Patent Office, Wellington C 1.

Patents Act 1953 Notice of opposition by patentee or by any person interested to cancellation of endorsement of a patent licences of right (To be accompanied by a copy, and a statement of a case in duplicate) I (or WE), [State name and address], hereby give notice of opposition to the application for the cancellation of the endorsement Licences of right in respect of patent No ......... Communications should be sent to at [The address must be within New Zealand], who is (or are) hereby appointed to act for me (or us). [To be signed by the opponent] To the Commissioner, The Patent Office, Wellington C 1.

Patents Act 1953 Application for compulsory licence or for compulsory endorsement licences of right

Patents Act 1953 Application by government department under section 49(1)

Patents Act 1953 Application under section 50 for revocation of a patent I (or WE), [State name and address], hereby apply for the revocation of patent No ............... for the following reasons: [State the nature of applicant's interest, the facts upon which he relies, and the grounds upon which the application is made]. Communications should be sent to ............ at [The address must be within New Zealand], who is (or are) hereby appointed to act for me (or us). Signature:....................... To the Commissioner, The Patent Office, Wellington C 1.

Patents Act 1953 Notice of opposition under section 52 to an application for an order under section 46, 49, 50, or 51 (To be accompanied by evidence verifying the statement below of grounds on which application is opposed)

Patents Act 1953 Application under section 51 for licence

Patents Act 1953 Application for directions under section 6(1) (To be accompanied by a statement of case and by copies of the application and statement as required by regulation 122) I (or WE), [State name and address], hereby apply for the following directions in respect of patent No ............... : [State the directions sought]. Communications should be sent to ............ at [The address must be within New Zealand], who is (or are) hereby appointed to act for me (or us). [To be signed by the patentee seeking directions.] To the Commissioner, The Patent Office, Wellington C 1.

Patents Act 1953 Application for directions under section 64(2) (To be accompanied by a copy and a statement of case in duplicate) I (or WE), [State name and address of patentee or joint patentees], hereby apply for directions in respect of the failure of [State name of person in default] to comply with the directions of the Commissioner given under section 64(1) of the Patents Act 1953 on the in the following matter: [State the directions sought]. Communications should be sent to .............. at [The address must be within New Zealand], who is (or are) hereby appointed to act for me (or us). [To be signed by the patentee.] To the Commissioner, The Patent Office, Wellington C 1.

Patents Act 1953 Application under section 65(1) to determine a dispute between employer and employee as to rights in an invention (To be accompanied by a copy and a statement in duplicate setting out the facts of the dispute and the relief sought) I (or WE) [State name and address], hereby declare that in respect of the rights in the invention for which an application for a patent was made by .................... and numbered .................. (and upon which a patent has been granted*), a dispute has arisen between me (or us) and [State name and address of other party to dispute] and I (or we) hereby apply to the Commissioner to determine the dispute. The facts of the dispute, and the relief which I (or we) seek are set out fully in the accompanying statement. Communications should be sent to ............... at [The address must be within New Zealand], who is (or are) hereby appointed to act for me (or us). Signature: ................... * Delete if a patent has not been granted. To the Commissioner, The Patent Office, Wellington C 1.

Patents Act 1953 Request for alteration of a name or nationality or an address or an address for service in the register of patents In the matter of Patent No .............. I (or WE), [State (in full) name and address of applicant or applicants], hereby request that the name (or nationality or address or address for service) now upon the register of patents may be altered to [Insert name, nationality, or address or address for service, as the case may be]. Signature of Applicant or Applicants: ..................... NOTE.—Where the request is for alteration in a name or nationality, evidence of the alteration must be furnished. To the Commissioner, The Patent Office, Wellington C 1.

Patents Act 1953 Application for entry of name of proprietor or co-proprietor in the register of patents I (or WE), [Insert (in full) name, address, and nationality], hereby apply that you will enter my (or our) name in the register of patents as proprietor(s) (or co-proprietor(s) ) of patent No .............. at present registered in the name of [Give name of registered proprietor].* I (or We) claim to be so entitled by virtue of [Specify the particulars of the document, giving its date and the parties thereto, and showing how the claim here made is substantiated]. And in proof whereof I (or we) transmit the accompanying [Insert the nature of the document. The certified copy should be written, typewritten, or printed on [A4 international standard size] paper on one side only] with a certified copy thereof. My (or Our) address for service in New Zealand is ............... Signature: ................ [State in what capacity the signatory is acting.] *If the application is in respect of more than one patent, the numbers thereof, as well as the particulars required above as to the registered proprietor, should be given in a separate schedule, which should be attached to this form. To the Commissioner, The Patent Office, Wellington C 1.

Patents Act 1953 Application for entry of notice of a mortgage or licence in the register of patents I (or WE), [Insert (in full) name, address, and nationality] hereby apply that you will enter in the register of patents a notice of the following interest in a patent: I (or We) claim to be entitled [Insert the nature of the claim, whether by way of mortgage or licence] to an interest in patent No ...........,* at present registered in the name of [Give name of registered proprietor] by virtue of [Specify the particulars of the document, giving its date and the parties thereto]. And in proof whereof I (or we) transmit the accompanying [Insert the nature of the document. The certified copy should be written, typewritten, or printed on [A4 international standard size] paper on one side only] with a certified copy thereof. My (or Our) address for service in New Zealand is ................. Signature :............ [State in what capacity the signatory is acting.] * If the application is in respect of more than one patent, the numbers thereof, as well as the particulars required above in respect of the nature of the claim and the document, should be given in a separate schedule, which should be attached to this form. To the Commissioner, The Patent Office, Wellington C 1.

Patents Act 1953 Application under section 84(2) by assignor for entry of name of proprietor or co-proprietor in the register of patents I (or WE), [Insert (in full) name and address], hereby apply that you will enter the name(s) of [Insert name, address, and nationality of person(s) to be registered] in the register of patents as proprietor (or part proprietor) of patent No ...........,* of which I am (or we) are the registered proprietor(s). He is (or they are) entitled to the said patent or to a share therein by virtue of [Specify the particulars of the document, giving its date and the parties thereto, and showing how the claim here made is substantiated]. And in proof whereof I (or we) transmit the accompanying [Insert the nature of the document. The certified copy should be written, typewritten, or printed on [A4 international standard size] paper on one side only] with a certified copy thereof. My (or Our) address for service in New Zealand is ............. The address for service in New Zealand of the person(s) to be registered as proprietor or co-proprietor is: .......................... Signature:................... [State in what capacity the signatory is acting.] * If the application is in respect of more than one patent, the numbers thereof, as well as the particulars required above in respect of the person(s) to be registered and the document, should be given in a separate schedule, which should be attached to this form. To the Commissioner, The Patent Office, Wellington C 1.

Patents Act 1953 Application under section 8(2) by mortgagor or licensor for entry of notice of a mortgage or licence in the register of patents I (or WE), [Insert (in full) name and address], hereby apply that you will enter in the register of patents a notice of the following interest in a patent: [Insert name, address, and nationality of mortgagee or licensee.] He is (or they are) entitled [Insert the nature of the claim, whether by way of mortgage or licence] to an interest in patent No ...........,* of which I am (or we are) the registered proprietor(s), by virtue of [Specify the particulars of the document, giving its date and the parties to the same.] * If the application is in respect of more than one patent, the numbers thereof, as well as the particulars required above in respect of the nature of the claim and the document, should be given in a separate schedule, which should be attached to this form. And in proof whereof I (or we) transmit the accompanying [Insert the nature of the document. The certified copy should be written, typewritten, or printed on [A4 international standard size] paper on one side only] with a certified copy thereof. My (or Our) address for service in New Zealand is ................... The address for service in New Zealand of the person (s) to be registered as mortgagee or licensee is ................. Signature: ....................... [State in what capacity the signatory is acting.] To the Commissioner, The Patent Office, Wellington C 1.

Patents Act 1953 Application for entry of notification of document in register of patents I (or WE), [Insert (in full) name, address, and nationality of the party who benefits under the document], transmit the accompanying [Specify the particulars of the document, giving its nature, date, and the parties thereto] (together with a certified copy thereof) [The certified copy should be written, typewritten, or printed on [A4 international standard size] paper on one side only] affecting the proprietorship of patent No.........,* at present registered in the name of [State name of registered proprietor], and request that a notification thereof may be entered in the register of patents. Signature:................... [State in what capacity the signatory is acting.] * If the application is in respect of more than one patent, the numbers and particulars thereof should be given in a separate schedule, which should be attached to this form. To the Commissioner, The Patent Office, Wellington C 1.

Patents Act 1953 Application for entry in the register of patents of a claim to be deemed a licence. I (or WE), [State name, address, and nationality], hereby apply that you will enter my (or our) claim to be deemed to have acted with the licence of the patentee (exclusive licensee) in accordance with the conditions in the order dated .................. extending the term of patent No ............ Evidence in support of my (or our) claim accompanies this application. My (or Our) address for service in New Zealand is ............... Signature: .................... To the Commissioner, The Patent Office, Wellington C 1.

Patents Act 1953 Application under section 86 for leave to dispense with production of probate or letters of administration I (or WE), [State (in full) name, address, occupation, and nationality], hereby apply for leave to dispense with the production of probate of the will (or letters of administration in the estate) of [Name of deceased, in full], deceased (hereinafter referred to as the deceased), who was the [Inventor, applicant, or patentee] of the invention entitled [Short title of invention] the subject of application for the grant of letters patent No ......... in New Zealand. The circumstances in and the grounds upon which this application is made are as follows: 1. The deceased died testate (or intestate) at ............... on the ................. day of ......... 19 ....., and at his death was domiciled in [State country of domicile]. 2. I am entitled to obtain probate of the will of the deceased (or letters of administration in the deceased's estate). Or,— I am the legal representative of the deceased in the country of his domicile by virtue of probate (or letters of administration) granted to me by [Title of official or name of Court making] at .................. on the .................. day of ............. 19..... 3. Probate of the will of the deceased has (or letters of administration in the deceased's estate have) not been granted or resealed in New Zealand. 4. No duty is payable in New Zealand in the estate of the deceased, as is evidenced by the certificate by the Commissioner of Inland Revenue annexed hereto. 5. The interests of the creditors of the deceased and of all persons beneficially interested under his will or in his estate will be adequately safeguarded in the manner following: .................... Communications should be sent to ............. at [The address must be within New Zealand], who is (or are) hereby appointed to act for me (or us). [To be signed by all persons making the application.] To the Commissioner, The Patent Office, Wellington C 1.

Patents Act 1953 Request for correction of error (section 88) I (or WE), [State full name and address], hereby request that the clerical error(s) in the [State whether in application, specification, entry in register, patent, or the particular relevant document] relating to application (or patent) No .............. indicated in red ink in the annexed copy of the said [State whether in application, specification, entry in register, patent, or the particular relevant document] or shown as follows ................... may be corrected. Communications should be sent to ............ at [The address must be within New Zealand], who is (or are) hereby appointed to act for me (or us). [To be signed by applicant or his authorized agent.] To the Commissioner, The Patent Office, Wellington C 1.

Patents Act 1953 Notice of opposition to the correction of a clerical error (To be accompanied by a copy and a statement of case in duplicate) I (or WE), [State (in full) name and address], hereby give notice of opposition to the correction of an alleged clerical error in ................, which said correction has been applied for by ..................... The grounds upon which the said correction is opposed are as follows:.................. Communications should be sent to ............. at [The address must be within New Zealand], who is (or are) hereby appointed to act for me (or us). [To be signed by opponent or opponents.] To the Commissioner, The Patent Office, Wellington C 1.

Patents Act 1953 Request for certificate of Commissioner Patent (or Application) No ........... of 19... I (or WE), ................, of .................. hereby request you to furnish me (or us) with your certificate to the effect that [Here set out the particulars which the Commissioner is requested to certify, and of any copies of documents which are to be annexed to the certificate stating also the purpose for which the copies are required. Give the name and full address to which certificate is to be sent.] To the Commissioner, The Patent Office, Wellington C 1.

Patents Act 1953 Request for information as to a matter affecting a patent or an application therefore Patent (or Application) No ............. of 19.... I (or WE), ................, of .............., hereby request you to furnish me (or us) with the following information affecting the patent (or application) aforesaid: [Here set out particulars as to the matter in respect of which information is sought]. [To be signed by the person or persons seeking information, or by their agent.] To the Commissioner, The Patent Office, Wellington C 1.

Patents Act 1953 Application under section 92 for letters patent I (or WE), have to inform you that the letters patent dated [State date, number, and full name and address of grantee or grantees], No ............ granted to ............... for an invention the title of which is [Insert title of invention] has been lost or destroyed, or cannot be produced in the following circumstances: [State (in full) the circumstances of the case, which must be verified by evidence]. I (or We) beg therefore to apply for the reissue of the letters patent. [State interest possessed by applicant or applicants in the patent.] [Signature of patentee or patentees and full address to which the duplicate is to be sent.] To the Commissioner, The Patent Office, Wellington C 1.

Patents Act 1953 In the matter of.............. To [State name, address, and occupation]. SUMMONS TO WITNESS IN pursuance of the powers conferred upon me by section 96 of the Patents Act 1953 and by the regulations in force thereunder, I hereby require you to attend before me at .........., on ........, the ........... day of ............, 19.... at ............. o'clock of the .............. noon, to give evidence on behalf of in the above-mentioned proceedings (and then and there to have and produce [State any particular documents required], and all other books, deeds, papers, or other writings in your possession or under your control relating to the said proceedings.)* If you fail to comply with the provisions of this summons you are liable to a fine of £20. Given under my hand at ..........., this ........... day of .......... 19.... Commissioner of Patents. * Delete if not applicable.

Patents Act 1953 Application for entry of order of Court in the register I (or WE), [State (in full) name and address of applicant or applicants], hereby transmit a sealed duplicate (or certified copy) of an order of the Court with reference to [State the purport of the order]. Signature:................... To the Commissioner, The Patent Office, Wellington C 1.

Patents Act 1953 Application under regulation 168 for extension of time I (or WE), [State name and address], hereby apply for an extension of the time for [State matter in respect of which extension of time sought] in respect of application No ............ The circumstances in and grounds upon which this application is made are as follows: [The circumstances and grounds must be stated in detail]. Communications should be sent to ................ at [The address must be in New Zealand]. Signature:................. To the Commissioner, The Patent Office, Wellington C 1.

Form of patent (New Zealand Arms) Letters patent ELIZABETH THE SECOND, by the Grace of God of the United Kingdom, New Zealand and Her Other Realms and Territories Queen, Head of the Commonwealth, Defender of the Faith: To all to whom these presents shall come, Greeting: WHEREAS pursuant to the Patents Act 1953 an application has been made for a patent of an invention for .............. (more particularly described in the complete specification relating to the application) AND WHEREAS ................ of ................ (hereinafter together with his or their successors and assigns or any of them called the patentee) is entitled to be registered as the proprietor of the patent hereinafter granted: Now, THEREFORE, We by these letters patent give and grant to the patentee our special licence, full power, sole privilege, and authority, that the patentee by himself, his agents or licensees and no others, may subject to the provisions of any statute or regulation for the time being in force make, use, exercise, and vend the said invention within New Zealand and its dependencies during a term of sixteen years from the date hereunder written and that the patentee shall have and enjoy the whole profit and advantage from time to time accruing by reason of the said invention during the said term: AND we strictly command all our subjects whomsoever within New Zealand and its dependencies that they do not at any time during the said term either directly or indirectly make use of or put into practice the said invention, nor in any way imitate the said invention without the consent, licence, or agreement of the patentee in writing under his hand, on pain of incurring such penalties as are prescribed by law and of being answerable to the patentee according to law for his damages thereby occasioned:

PROVIDED ALWAYS: (1) That these letters patent shall determine and become void if the patentee does not from time to time pay the renewal fees prescribed by law in respect of the patent: (2) That these letters patent are revocable on any of the grounds prescribed by the Patents Act 1953 as grounds for revoking letters patent: (3) That nothing in these letters patent shall prevent the granting of licences in the manner in which and for the considerations on which they may by law be granted: (4) That these letters patent shall be construed in the most beneficial sense for the advantage of the patentee. IN WITNESS whereof We have caused these letters patent to be signed and sealed as of the .......... day of ............ 19..... Commissioner of Patents. [SEAL OF PATENT OFFICE]

Form of patent of addition (New Zealand Arms) letters patent ELIZABETH THE SECOND, by the Grace of God of the United Kingdom, New Zealand and Her Other Realms and Territories Queen, Head of the Commonwealth, Defender of the Faith: To all to whom these presents shall come, Greeting: WHEREAS pursuant to the Patents Act 1953 an application has been made for a patent of an invention for ................. (more particularly described in the complete specification relating to the application) AND WHEREAS it has been requested that the patent may be granted as a patent of addition to patent No ................ dated the ................ day of ................ 19 ....., (hereinafter called the main patent) AND WHEREAS .............. of ............. (hereinafter together with his or their successors and assigns or any of them called the patentee) is entitled to be registered as the proprietor of the patent hereinafter granted: Now, THEREFORE, We by these letters patent give and grant to the patentee our special licence, full power, sole privilege, and authority, that the patentee by himself, his agents, or licensees and no others, may subject to the provisions of any statute or regulation for the time being in force make, use, exercise, and vend the said invention within New Zealand and its dependencies during a term beginning on the ........ day of ........... 19 ...... and ending at the expiration of sixteen years from the ....... day of ....... 19...., the date of the said main patent and that the patentee shall have and enjoy the whole profit and advantage from time to time accruing by reason of the said invention during the said term: AND we strictly command all our subjects whomsoever within New Zealand and its dependencies that they do not at any time during the said term either directly or indirectly make use of or put into practice the said invention, nor in any way imitate the said invention without the consent, licence, or agreement of the patentee in writing under his hand on pain of incurring such penalties as are prescribed by law and of being answerable to the patentee according to law for his damages thereby occasioned:

PROVIDED ALWAYS: (1) That these letters patent are revocable on any of the grounds prescribed by the Patents Act 1953 as grounds for revoking letters patent: (2) That nothing in these letters patent shall prevent the granting of licences in the manner in which and for the considerations on which they may by law be granted: (3) That these letters patent shall be construed in the most beneficial sense for the advantage of the patentee. IN WITNESS whereof We have caused these letters patent to be signed and sealed as of the ......... day of ............ 19...... Commissioner of Patents. [SEAL OF PATENT OFFICE]