DM/4(E)
HAGUE AGREEMENT
CONCERNING THE INTERNATIONAL REGISTRATION OF INDUSTRIAL DESIGNS
RENEWAL OF THE INTERNATIONAL REGISTRATION
GOVERNED EXCLUSIVELY OR PARTLY BY THE 1999 ACT AND/OR THE 1960 ACT
IMPORTANT
1. This form may only be used to request the renewal of a single international registration resulting from
an international application governed exclusively or partly by the 1999 Act and/or the 1960 Act. If
the international registration results from an international application governed exclusively by the
1934 Act, form DM/35 must be used.
2. With respect only to Contracting Parties designated under the 1934 Act, the international registration
cannot be renewed beyond the maximum duration of protection of 15 years.
3. A Fee Calculator is available on the WIPO’s web site, at
http://www.wipo.int/hague/en/fees/calculator.jsp.
This cover page must not be sent to the International Bureau.
World Intellectual Property Organization
34, chemin des Colombettes, P.O. Box 18,
1211 Geneva 20, Switzerland
Tel.: +41 (0)22 338 91 11
Fax (The Hague Registry): +41 (0)22 740 14 29
e-mail: intreg.mail@wipo.int – Internet: http://www.wipo.int
DM/4(E) – July 2014
DM/4(E)
RENEWAL OF THE INTERNATIONAL REGISTRATION
GOVERNED EXCLUSIVELY OR PARTLY BY THE 1999 ACT AND/OR THE 1960 ACT
For use by the holder
This request contains the following number of continuation sheets:
Reference:
1
INTERNATIONAL REGISTRATION NUMBER
Date:
2
NAME AND ADDRESS OF THE HOLDER (as recorded in the International Register)
Name:
Address:
3
SCOPE OF THE RENEWAL (check item (a) or complete item (b))
(a)
TOTAL RENEWAL: the renewal of the international registration is to be recorded for all designs included in that international
registration and for all designated Contracting Parties – including, where applicable, those Contracting Parties in respect of which a
total refusal has been recorded in the International Register and those Contracting Parties designated under the 1999 Act or the 1960 Act
in respect of which the maximum period of protection has expired.
_________________________________________________________________________
(b)
PARTIAL RENEWAL
(i) Indicate below the number of each industrial design for which the international registration is NOT to be renewed; if no industrial
design number is indicated, it will be understood that all industrial designs indicated in item 1 will be the subject of the renewal:
(ii) Indicate below the designated Contracting Parties for which the international registration is NOT to be renewed1:
AL
AM
AZ
BA
BG
BJ
1
4
BN
BW
BX
BZ
CH
CI
DE
DK
EE
EG
EM
ES
FI
FR
GA
GE
GH
GR
HR
HU
IS
IT
KG
KP
KR
LI
LT
LV
MA
MC
MD
ME
MK
ML
MN
NA
NE
NO
OA
OM
PL
RO
RS
RW
SG
SI
SN
SR
ST
SY
TJ
TN
TR
UA
It is understood that the renewal is to be recorded in respect of all designated Contracting Parties not indicated above (including,
where applicable, those in respect of which a total refusal has been recorded in the International Register and those designated under
the 1999 Act or the 1960 Act in respect of which the maximum period of protection has expired).
APPOINTMENT OF A REPRESENTATIVE (optional)
(do not complete this item if there is no change in the representative already recorded in the International Register)
(a) Name:
(b) Address:
Telephone:
Fax:
E-mail address:
(c) To appoint a representative, the present request must be signed by the holder, or accompanied by a power of attorney or form DM/7
(check the appropriate box):
item 5 of the request is signed by the holder; or
a power of attorney or form DM/7 is attached to the present form
DM/4(E) – July 2014
Page 2
5
SIGNATURE AND/OR SEAL
(a) Identify the signatory by checking the appropriate box:
(i) Holder
(ii) Representative of the holder
(b) Name:
(c) Signature and/or seal:
(d) Date of Signature (dd/mm/yyyy):
Name of the person to contact, if necessary:
Telephone:
Fax:
E-mail address:
PAYMENT OF FEES
1. INSTRUCTION TO DEBIT FROM A CURRENT ACCOUNT
(if this box is completed, it is not necessary to complete items 2 and 3)
The International Bureau is hereby instructed to debit the required amount of fees from the following current account opened with the
International Bureau:
Holder of the account:
Account number:
Identity of the party giving the instruction:
2. METHOD OF PAYMENT
Identity of the party effecting the payment:
Payment made to WIPO bank account
IBAN No. CH51 0483 5048 7080 8100 0
Credit Suisse, CH-1211 Geneva 70
Swift/BIC: CRESCHZZ80A
Payment made to WIPO postal account
IBAN No. CH03 0900 0000 1200 5000 8
Swift/BIC: POFICHBE
Payment identification
dd/mm/yyyy
Payment identification
dd/mm/yyyy
GRAND TOTAL IN SWISS FRANCS (use the fee calculator or complete item 3 below)
DM/4(E) – July 2014
Page 3
FEE CALCULATION
This item is provided for the convenience of users.
It is not necessary to complete it if the fee calculator is used.
3. AMOUNT OF FEES (see Fee Calculator: www.wipo.int/hague_feecalc)
(a)
Basic fees
for one design
for each additional design
17 Swiss francs 
designs in addition to the first
(b)
200.--
Designation fees
(i) Standard designation fees (payable only for designations renewed under the 1960 Act or for
designations renewed under the 1999 Act and for which an individual designation fee is not payable)
for first design
21 Swiss francs 
for each additional design
1 Swiss franc 
Contracting Parties
designs in addition to the first 
Contracting Parties
(ii) Individual designation fee
European
Union:
34 Swiss francs for each design 
Hungary*:
84 Swiss francs for first design + 20 Swiss francs 
designs in addition to the first
Kyrgyzstan*:
64 Swiss francs for first design + 6 Swiss francs 
designs in addition to the first
OAPI:
190 Swiss francs for each design 
Republic of
Korea:
First renewal: 339 Swiss francs for each design x
Second renewal: 800 Swiss francs for each design x
Third renewal: 923 Swiss francs for each design x
Republic of
Moldova*: 128 Swiss francs for first design + 13 Swiss francs 
*
designs in addition to the first
Payable only if the designation of these Contracting Parties is renewed under the 1999 Act.
(c)
Surcharge – period of grace (payable only if the payment of fees is made after the date on which the renewal
of the international registration was due)
50% of the renewal basic fee
GRAND TOTAL (SWISS FRANCS)
DM/4(E) – July 2014