IPO Form PETITION FOR RENEWAL OF REGISTRATION Mark: Reg. No.: Issue Date: Class: TO THE DIRECTOR: Petitioner, _______________________________, a corporation of duly organized under the laws of ________________________ with address at ______________________ _________________________________________________________________________ requests that the above-identified registration which it owns be renewed in accordance with the provision of Republic Act No. 8293. Pursuant to the rules and regulations, Petitioner hereby encloses a copy of the Certificate of Registration No.___________, and the required fee. Petitioner further declares that: [ ] The above-identified Mark is in use in commerce in the Philippines on the goods/services recited in the registration, except that the use of said Mark was discontinued on the following goods: _____________________________________________________ _________________________________________________________________________ [ ] The right to the Mark has been granted to the following: ______________________ _________________________________________________________________________ _ [ ] There is no material variation in the manner of display of the Mark. [ ] There is material variation in the manner of display of the Mark. Enclosed herewith are five (5) labels, pictures of the products, website printouts showing the mark as customarily used. Petitioner hereby appoints FEDERIS & ASSOCIATES LAW OFFICES of Suites 2004 and 2005, 88 Corporate Center, 141 Valero St., Salcedo Village, Makati City, 1227 Philippines, members of the Philippine bar, as its agent or its attorney to file this petition, to transact business in the Intellectual Property Office (“IPO”) in connection therewith. The said law office is also authorized to prepare and execute all other documents necessary to renew the registration, including but not limited to responding to Office Action, to payment of fees. Petitioner hereby grants upon the said firm the authority to transact all business with the IPO necessary to maintain the said subject registration. Dated:_____________________________. _____________________________ Name: Official Title: (To be notarized, no legalization required)