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| Date: |
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| Entitlement (Hague Act(1960)): |
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| Entitlement (Geneva Act (1999)): |
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| Add the number of designs: |
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| Add the number of reproduction(s) of the design(s): |
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| If using the paper application form, add the number of pages of reproductions: (free if you use the e-filing interface) |
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| Add the number of words of description: |
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| Locarno Classification (for KR designations only): |
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| Economic Status (for US designations): |
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| Economic Status (for IL designations): |
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| Economic Status (for MX designations): |
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