SINGAPORE PATENTS ACT (CHAPTER 221)
PATENTS RULESPATENTS FORM 14

Payment of Fee for Grant of Patent

Pre-requisites:a. In general, where the specification of the application has been amended or corrected since the filing of the application, aspecification incorporating every such amendment or correction is to accompany this form.
Estimated Time:
This form may take approximately 8 - 12 minutes to complete.
General:a. * denotes mandatory fields.
b. An additional fee of $20 for each patent claim in excess of 25 patent claims is payable for patent applications having:−a date of filing on or after 01/07/2004; or−a date of filing before 01/07/2004 but the application was lodged on or after 14/02/2014
c. Attention is drawn to sections 104 and 105 of the Patents Act, rules 90 and 105 of the Patents Rules, and the Patents(Patent Agents) Rules 2001.

PART 1

Reference
Applicant/ Agent
Reference

PART 2

Application No.*
Application No.*

Title of Invention
Select Preferred Title of Invention(Applicable for PF37 Applications)
Title on Record
Title on Consolidated Specification
PART 3Name of Applicant*Note: If there is insufficient space, please use the continuation sheet CS 4.

UEN/ Company Code(if applicable)

Name

Sole Proprietor orPartners' Name
(if sole proprietorship orpartnership)

PART 4

Indication for applications having a date of filing on or after 1 July 2004
No. of Claims

V1.20170401

No. of claims contained in the specification of this patent application at
the time of compliance with rule 47(3) of the Patents Rules

Page 1 of 4

PART 5Declaration for applications lodged before 14 Feb 2014 and having a date of filingon or after 1 Jul 2004
Declaration

PART 6

I/ We declare that the application has satisfied the conditions referred
to in sections 30(3)(b) or (c) (whichever is applicable) and 30(3)(e) ofthe Patents Act.

Contact Details*

Note:a. Where an agent with UEN is appointed, the fields for "Agent UEN/ Company Code", "Agent Name" and "Address forService in Singapore" should be completed. Where an individual or an agent without UEN is appointed, the sub-field“Representative or C/O Name” and "Address for Service in Singapore" should be completed instead.
b. The official correspondence will be sent to the address for service in Singapore as indicated in this box, and must be thesame as the one on our record.
c. Please file Form CM1 if you are a different agent or Form CM2 if you have changed your address for service in Singapore.

Agent UEN/ Company
Code
Agent Name

Representative or C/OName
Address for Service in Singapore
Block/ HouseNo.
Street Name
Level - Unit-

Building
Name
Postal CodeContact Person(if applicable)

Direct Telephone No.
(if applicable)

Email Address(if applicable)

PART 7

Declaration*
Declaration

By Person Filing the FormI, the undersigned, do hereby declare that the information furnishedabove is true to the best of my knowledge. I understand that I may beliable for criminal prosecution for providing any false information in thisapplication.
By Agent

V1.20170401

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I, the undersigned, do hereby declare that:i.

I have been duly authorised to act as an agent on behalf of theperson(s) filing this form.

ii.

The information furnished above on behalf of the person(s) filingthis form is true to the best of the person(s)' knowledge. I
understand that I may be liable for criminal prosecution forproviding any false information in this application.

NameSignatureDate(DD/MM/YYYY)

No. of Extra Sheets
Attached to this Form

V1.20170401

sheet(s)Page 3 of 4

GST

GST INFORMATIONTax Invoice*Note:
Tax invoice will be issued to the entity/individual as indicated. Goods and Services Tax (GST)-registered businesses may claim
input tax with Inland Revenue Authority of Singapore (IRAS), subject to meeting the requirements under the GST Act.

The name of the Applicant (as in PART 3 of this form) is to be indicated in this field.

Name (Tax invoice to beissued to)V1.20170401

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