■ 상표법 시행규칙 [별지 제36호서식] 사후지정신청서
MM4(E) MADRID AGREEMENT AND PROTOCOL CONCERNING THE INTERNATIONAL REGISTRATION OF MARKS DESIGNATION SUBSEQUENT TO THE INTERNATIONAL REGISTRATION (Rule 24 of the Common Regulations)
	IMPORTANT: 1. This subsequent designation must be presented to the International Bureau: (a) through the Office of the Contracting Party of the holder where any Contracting Party is designated under the Madrid Agreement (b) through the Office of origin where Rule 7(1)(as in force before October 4, 2001) applies (c) in all other cases, either directly by the holder or by the Office if the Contracting Party of the holder. 2. The period of protection of a subsequent designation expires on the same date as the international registration to which it relates.
World Intellectual Property Organization 34. chemin des Colombettes, P.O. Box 18, 1211 Geneva 20, Switzerland Tel.: (41-22) 338-9111 Fax(International Trademark Registry): (41-22) 740-1429 E-mail: interg.mail@wipo.int-Internet: http://www.wipo.int

DESIGNATION SUBSEQUENT TO THE INTERNATIONAL REGISTRATION
For use by the holder This subsequent designation contains the following number of continuation sheets: ................................................			For use by the holder/Office Holder’s reference:....................... Office’s reference:............................
INTERNATIONAL REGISTRATION NUMBER:............................................
HOLDER OF THE INTERNATIONAL REGISTRATION (as recorded in International Register) Name:................................................................................................................ ............................................................................................................................ Address:............................................................................................................
APPOINTMENT OF A REPRESENTATIVE (Do not complete this item if there is no change in the representative already recorded in the International Register) Name:.............................................................................................................. Address:.......................................................................................................... ................................................................ Telephone:..................................... Fax:...................................................... E-mail address:............................. SIGNATURE OF THE HOLDER APPOINTING THE ABOVE (NEW) REPRESENTATIVE ..........................................................................................................................
CONTRACTING PARTIES DESIGNATED SUBSEQUENTLY
□ AG Antigua and	□ CN China			□ GR Greece
Barbuda	□ CU Cuba			□ HR Croatia
□ AL Albania	□ CY Cyprus			□ HU Hungary
□ AM Armenia	□ CZ Czech Republic			□ IE Ireland¹
□ AT Austria	□ DE Germany			□ IS Iceland
□ AU Australia	□ DK Denmark			□ IT Italy
□ AZ Azerbaijan	□ DZ Algeria			□ JP Japan
□ BA Bosnia and	□ EE Estonia			□ KE Kenya
Herzegovina	□ EG Egypt			□ KG Kyrgyzstan
□ BG Bulgaria	□ ES Spain			□ KP Democratic Peo-
□ BT Bhutan	□ FI Finland			ple’s Republic of
□ BX Benelux	□ FR France			Korea
□ BY Belarus	□ GB United Kingdom¹			□ KR Republic of Korea
□ CH Switzerland	□ GE Georgia			□ KZ Kazakhstan
□ LI Liechtenstein	□ MZ Mozambique			□ SM San-Marino

□ LR Liberia	□ NO Norway	□ SZ Swaziland
□ LS Lesotho	□ PL Poland	□ TJ Tajikistan
□ LT Lithuania	□ PT Portugal	□ TM Turkmenistan
□ LV Latvia	□ RO Romania	□ TR Turkey
□ MA Morocco	□ RU Russian Federation	□ UA Ukraine
□ MC Monaco	□ SD Sudan	□ US United States of
□ MD Rep. of Moldova	□ SE Sweden	America²
□ MK The former Yu-	□ SG Singapore¹	□ UZ Uzbekistan
goslav Rep. of	□ SI Slovenia	□ VN Viet Nam
Macedonia	□ SK Slovakia	□ YU Serbia and
□ MN Mongolia	□ SL Sierra Leone	montenegro
		□ ZM Zambia
others: ........................................ ........................................ ........................................
¹ By designating Ireland, Singapore or the United Kingdom, the holder declares that he has the intention that the mark will be used by him or with his consent in that country in connection with the goods and services identified in the present subsequent designation. ² If the United States of America is designated it is compulsory to annex to the present subsequent designation the official form (MM18) containing the declaration of intention to use the mark required by the Contracting Party.
GOODS AND SERVICES CONCERNED BY THE SUBSEQUENT DESIGNATION (check only one box) (a) □ The subsequent designation is made, in respect of all the Contracting Parties designated in item 4, for all the goods and services listed in the international registration indicated in item 1; or (b) □ The subsequent designation is made, in respect of all the Contracting Parties designated in item 4, only for those goods and services listed in the continuation sheet[which must be grouped in the appropriate class(es)]; or (c) □ The subsequent designation is only for those goods and services listed in the continuation sheet in respect of the Contracting Parties identified in the said continuation sheet; in respect of the other Contracting Parties designated in item 4, the subsequent designation is for all the goods and services listed in the international registration identified in item 1.
MISCELLANEOUS INDICATIONS (a) Indications concerning the holder(as may be required by certain designated Contracting Parties): (i) if the holder is a natural person, nationality of the holder:........... (ii) if the holder is a legal entity: - legal nature of the legal entity:................................................... - state and, where applicable, territorial unit within that state, under the law of which the legal entity is organized:........................................................................................................ (b) Indication, for each color, of the principal parts of the mark that are in that color(as may be required by certain designated Contracting Parties): .................................................................................................................... .................................................................................................................... .................................................................................................................... (c) Translation of the mark(as may be required by certain designated Contracting Parties): (i) into English:........................................................................................ ............................................................................................................... (ii) into French:........................................................................................ ............................................................................................................... (d) If the words contained in the mark have no meaning(and therefore cannot be translated), check this box□
DATE OF EFFECT OF THE SUBSEQUENT DESIGNATION (If neither of these boxes is checked, the data of this subsequent designaton will be the data of its receipt by the International Bureau or, if it has been presented through the intermediary of an office, the data of receipt by that office) (a) □ This subsequent designation shall take affect immediately after the renewal of the international registration indicated in item 1; (b) □ This subsequent designation shall take affect immediately after the recording in the International Register of the following change concerning the international registration indicated in item 1(specify the change):

........................................................................................................................... ........................................................................................................................... ...........................................................................................................................
SIGNATURE BY THE HOLDER OR HIS REPRESENTATIVE
Holder (as recorded in the International Register) signature:................................................ signature:................................................		Representative of holder (as recorded in the International Register) Name:..................................................... signature:................................................
DATE OF RECEIPT AND DECLARATION BY THE OFFICE (where the subsequent designation is presented through an office) (a) Date of receipt of the subsequent designation by the office: .............................................................................................(dd/mm/yyyy) (b) Declaration that the basic application has matured to registration:
	Only applicable where: - the subsequent designation relates to an international registration which was based on a basic application: - the present subsequent designation is the first designating a Contracting Party under the Agreement, and - it is presented through the office of origin.
(i) Date of the registration resulting from the basic application: .............................................................................................(dd/mm/yyyy) (ii) Number of the registration resulting from the basic application: .....................................................................................................................
OFFICE PRESENTING THE SUBSEQUENT DESIGNATION (if applicable) Name of the office ................................................................................................................................. Signature and/or stamp of the office .................................................................................................................................

FEE CALCULATION SHEET
(a) INSTRUCTIONS TO DEBIT FROM A CURRENT ACCOUNT □ The International Bureau is hereby instructed to debit the required amount of fees from a current account opened with the International Bureau[if this box is checked, it is not necessary to complete(b)]. Holder of the account:..............................Account number:..................... Identity of the party giving the instructions:............................................
(b) AMOUNT OF FEES ; METHOD OF PAYMENT
Basic fee(300 Swiss francs) ................................. Complementary fees ; Number of designa- tions for which com- plementary fee is ap- Total amount of the plicable Complementary fee complementary fees ..............................×73 Swiss francs =.......................⇒............................. Individual fees(Swiss francs):
	Designated Con- Individual fee Designated Con- Individual fee tracting Parties tracting Parties ............................ ....................... ............................ ......................... ............................ ....................... ............................ ......................... ............................ ....................... ............................ ......................... ............................ ....................... ............................ .........................
Total individual fees ⇒................................. Grand total ................................. (Swiss francs) Identity of the party effecting the payment:.................................................... WIPO receipt number Payment received and ac- □...................................... knowledged by WIPO Check identification dd/mm/yyyy Payment made by banker’s □................................... ................................... cheque(attached) Check identification dd/mm/yyyy Payment made by banker’s □................................... ................................... cheque(sent separately) Payment identification dd/mm/yyyy Payment made to WIPO □................................... ...................................

bank account No CH35      □...................................       ............................

0425 7080 8100 0 credit

Suisse, CH-1211 Geneva 70

Swift: CRESCH ZZ12A

Payment made to WIPO        Payment identification     dd/mm/yyyy

Postal cheque account No    □...................................     .............................

12-5000-8, Geneva

CONTINUATION SHEET

No: ...................of..............