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In section 1, subsection 3(2) and section 5, 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.
(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.
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2. This application is a division of application number , filed in Canada on .
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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.
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4. The applicant requests priority in respect of the application on the basis of the following previously regularly filed application:
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The applicant appoints , whose complete address is , as the applicant's patent agent.
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.
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7. 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.