Forms
Copies of the forms required for the application package are provided in portable document format (PDF) and
in Microsoft Word (DOC) format on this website. The Word files have fields for the required information
and can be completed in electronic form. For the most up-to-date versions of the forms, consult the
 Canadian
Intellectual Property Office website for the Regime.
- "Application for Authorization Under Section 21.04 of the Patent Act"
(
45 kB; 
54 kB): Application for a compulsory licence to manufacture and
export a generic version of a patented pharmaceutical product or medical
device.
- "Solemn or Statutory Declaration Under Paragraph 21.04(3)(c) of the Patent Act"
(
70 kB; 43 kB):
Declaration that the applicant sought a voluntary licence from the patent
holder or holders.
- "Solemn or Statutory Declaration Under Paragraph 21.04(3)(d)(i)(A) of the Patent Act"
(
45 kB; 42 kB):
Declaration regarding the identity and patent status of the pharmaceutical
product or medical device (Schedule 2, WTO member, product not
patented).
- "Solemn or Statutory Declaration Under Paragraph 21.04(3)(d)(i)(B)
of the Patent Act"
(
41 kB; 39 kB):
Declaration regarding the identity and patent status of the pharmaceutical
product or medical device (Schedule 2, WTO member, product is patented).
- "Solemn or Statutory Declaration Under Paragraph 21.04(3)(d)(ii)(A)
of the Patent Act"
(
45 kB; 42 kB):
Declaration regarding the identity and patent status of the pharmaceutical
product or medical device (Schedule 2, not WTO member, product
not patented).
- "Solemn or Statutory Declaration Under Paragraph 21.04(3)(d)(ii)(B)
of the Patent Act"
(
41 kB; 40 kB):
Declaration regarding the identity and patent status of the pharmaceutical
product or medical device (Schedule 2, not WTO member, product
is patented).
- "Solemn or Statutory Declaration Under Paragraph 21.04(3)(d)(iii)(A),
(iv)(A) or (v)(A) of the Patent Act"
(
41 kB; 41 kB):
Declaration regarding the identity and patent status of the pharmaceutical
product or medical device (Schedule 3 or 4, product not patented).
- "Solemn or Statutory Declaration Under Paragraph 21.16(1)(b)
of the Patent Act"
(
45 kB; 43 kB):
Declaration regarding the monetary value of the pharmaceutical product
or medical device and the number of units to be manufactured and sold.
- "Application for Renewal of Authorization Under Section 21.12
of the Patent Act"
(
44 kB; 54 kB):
Application for renewal of authorization for compulsory licence.
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