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Canadian Intellectual Property Office Symbol of the Government of Canada


Format 4

Application for Registration of a Proposed Trade-mark

To: The Registrar of Trade-marks, Gatineau, Canada.

The applicant _____________________________________ whose full post office address of its principal office or place of business is


applies for the registration, in accordance with the provisions of the Trade-marks Act, of the trade-mark identified below.

The trade-mark is the word(s) (or is shown in the attached drawing)

The applicant, by himself/herself or through a licensee, or by himself/herself and through a licensee, intends to use the trade-mark in Canada in association with ____________________________________ and requests registration of the trade-mark in respect of such wares.

The applicant, by himself/herself or through a licensee, or by himself/herself and through a licensee, intends to use the trade-mark in Canada in association with _________________________________ and requests registration of the trade-mark in respect of such services.


The applicant is satisfied that he or she is entitled to use the trade-mark in Canada in association with the _________________________________ described above.


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