MM20(E) MADRID AGREEMENT AND PROTOCOL CONCERNING THE INTERNATIONAL REGISTRATION OF MARKS REQUEST FOR CONTINUED PROCESSING (Rule 5bis of the Common Regulations) IMPORTANT 1. This request for continued processing must be presented to the International Bureau: (a) where an applicant or holder has failed to comply with a time limit to (i) remedy specified irregularities under Rules 11(2), 20bis(2), 24(5)(b) or 26(2); (ii) pay the fees due for the international application under Rule 11(3); (iii) pay the second part of an individual fee under Rule 34(3)(c)(iii); (iv) file a request that an international registration continue its effects in a successor State and to pay the fees related to this request under Rule 39(1); (b) within two months from the date of expiry of that time limit. 2. The request must be (a) signed by the applicant or holder or the appointed representative; (b) accompanied with (i) the compliance of all the requirements in respect of which the missed time limit applied; (ii) the payment of the fee for continued processing specified in item 7.6 of the Schedule of Fees (200 Swiss francs). 3. A request for continued processing can be submitted only for the cases specified under Rule 5bis(1) (see item 1 above). It cannot be submitted for any other case of failure to comply with a time limit. World Intellectual Property Organization 34, chemin des Colombettes 1211 Geneva 20, Switzerland Tel. (Madrid Customer Service): +41 (0)22 338 8686 Fax (Madrid Registry): +41 (0)22 740 1429 e-mail: intreg.mail@wipo.int � Internet: www.wipo.int MM20(E) � February 2017 American LegalNet, Inc. www.FormsWorkFlow.com MM20(E) REQUEST FOR CONTINUED PROCESSING For use by the applicant or holder This request for continued processing contains the following number of continuation sheets: Applicant's or holder's reference: 1 WIPO REFERENCE NUMBER (Please, provide the 9 or 10-digit number that appears in the notice of irregularity or in the notification sent under Rules 34 or 39 as part of the WIPO reference number. Type one digit in each box. For example, for reference number EN-I/783955701/LB, type: 783955701) 2 PLEASE, PROVIDE ONE OF THE FOLLOWING (Where the request relates to more than one international registration, just provide the number of one of those registrations; where the request concerns an international application, please provide either the basic application number or the basic registration number) (a) International registration number: (b) Basic application number: (c) Basic registration number: 3 APPLICANT OF THE INTERNATIONAL APPLICATION (AS PROVIDED IN THE INTERNATIONAL APPLICATION) OR HOLDER OF THE INTERNATIONAL REGISTRATION (AS RECORDED IN THE INTERNATIONAL REGISTER) Name: 4 REQUEST FOR CONTINUED PROCESSING (Check the box that applies) The payment of fees in connection with an irregularity under Rules 11(2) and (3), 20bis(2), 24(5)(b) or 26(2). An irregularity relating to an international application or international registration under Rules 11(2) and (3), 20bis(2), 24(5)(b) or 26(2), but not to the payment of fees. The payment of the second part of an individual fee under Rule 34(3)(c)(iii). A request that an international registration continues its effects in a successor State and payment of the fees related to this request under Rule 39(1). 5 SIGNATURE BY THE APPLICANT, HOLDER AND/OR HIS REPRESENTATIVE Applicant or holder (as provided in the international application or recorded in the International Register) By signing this form, I declare that I am entitled to sign it under the applicable law: Name: Signature: Representative of the applicant or holder (as provided in the international application or recorded in the International Register) By signing this form, I declare that I am entitled to sign it under the applicable law: Name: Signature: MM20(E) � February 2017 American LegalNet, Inc. www.FormsWorkFlow.com FEE CALCULATION SHEET (a) INSTRUCTIONS TO DEBIT FROM A CURRENT ACCOUNT MM20(E), page 3 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: Identity of the party giving the instructions: (b) AMOUNT OF FEES (The fee for continued processing is 200 Swiss francs, irrespective of the number of international registrations listed in item 1) Account number: TOTAL (Swiss francs) (c) METHOD OF PAYMENT 200.-- Identity of the party effecting the payment: WIPO receipt number Payment received and acknowledged by WIPO Payment made to WIPO bank account IBAN No. CH51 0483 5048 7080 8100 0 Cr�dit Suisse, CH-1211 Geneva 70 Swift/BIC: CRESCHZZ80A Payment made to WIPO postal account (within Europe only) IBAN No. CH03 0900 0000 1200 5000 8 Swift/BIC: POFICHBE Payment identification dd/mm/yyyy Payment identification dd/mm/yyyy MM20(E) � February 2017 American LegalNet, Inc. www.FormsWorkFlow.com CONTINUATION SHEET No : .......... of .......... MM20(E) � February 2017 American LegalNet, Inc. www.FormsWorkFlow.com