P03-APPLICATION FOR AMENDMENT OR CORRECTION OF PATENT

REPUBLIC OF NAMIBIA

BUSINESS AND INTELLECTUAL PROPERTY

AUTHORITY (BIPA)

INDUSTRIAL PROPERTY ACT, 2012 Form No. P3

APPLICATION FOR AMENDMENT OR CORRECTION OF PATENT

OR UTILITY MODEL APPLICATION

(Section 28(1) and regulation 42(1) and (3))

Official Application No. Applicant’s or Agent’s Reference

Full Name(s) of Applicant(s)

Address for Service

Title of Invention

The applicant hereby applies to amend the specification contained in the above application as

shown on the attached relevant pages of that specification or to correct errors in the application.

The full reasons for making the amendment are as follows:

Signed this _________________________ day of _______________________________ 20 _____

____________________________

Signature (Applicant/Agent)

_______________________________________________________________________________

For Official Use:

Application Reference No.:

Official Date Stamp