Petition form

Here is an initial petition form for you to use. If you need help filling out the sections see the topic on petitions.

Please note: You must fill out Section 1 but some of the other sections may not apply to your patent application.

To fill out the form:

• Click the checkbox next to the section to select it; and
• Enter the information into the text boxes.

Once you have entered the information, click on the "View completed form" button at the bottom of the form to create a printable version. The questions you have not selected will not be redrawn. You can then print the form by selecting File, Print in your browser. If you make a mistake, click on the "Reset text fields" button to clear the form.

---

Form equivalent to Form 3

(Subsection 27(2) of the Patent Act)
Petition for Grant of a Patent

Instructions

In section 1, subsection 3(2) and sections 5 and 6, names and addresses must be presented in the following order with a clearly visible separation between the various elements: family name (in capital letters), given name(s), initials, or firm name, street name and number, city, province or state, postal code, telephone number, fax number and country.

In sections 5 and 6, appointment of representatives and appointment of patent agents may also be done in a separate document.

The applicant shall include in the petition or submit as a separate document a declaration in accordance with either subsection 3(1) or (2). If the subsection 3(2) declaration is included or submitted, it must be worded as above, with such inclusion, omission, repetition and re-ordering of the matters listed as items 3(2)(i) to (viii) as is necessary to explain the applicant's entitlement. Item numbers need not be included. This declaration is applicable only to those events that have occurred before the filing date. The possible kinds of transfer of entitlement in item 3(2)(vii) include merger, acquisition, inheritance, donation and so forth. If there has been a succession of transfers from the inventor, the order in which transfers are listed should follow the actual succession of transfers, and items may be included more than once, as necessary to explain the applicant's entitlement.

Requests for priority may be done in section 4 of the petition or in a separate document.

Small entity declarations may be done in section 7 of the petition or in a separate document. In accordance with 3.01(1)(e), the declaration, whether provided in the petition or in a separate document, must be signed by the applicant or patentee or by a patent agent appointed by the applicant or patentee.

SOR/2007-90, s. 28, and 29.

1. The applicant, , whose complete address is , requests the grant of a patent for an invention, entitled , which is described and claimed in the accompanying specification.
2. This application is a division of application number , filed in Canada on .
3(1) The applicant is the sole inventor.
(2) The applicant is entitled to apply for and be granted a patent by virtue of the following:
(i) (name) of (complete address) is the inventor of the subject matter for which protection is sought by way of this application, (ii) (name) [is] [was] entitled as employer of the inventor, (inventor's name),
(iii) an agreement between (name) and (name), dated ,
(iv) an assignment from (name) to (name), dated ,
(v) consent from (name) in favour of (name), dated ,
(vi) a court order issued by (name of court), effecting a transfer from (name) to (name), dated ,
(vii) transfer of entitlement from (name) to (name) by way of (specify kind of transfer), dated ,
(viii) the applicant's name changed from (name) to (name) on (date).
4. The applicant requests priority in respect of the application on the basis of the following previously regularly filed application:

Country of filing         Application number      Filing date

5. The applicant appoints , whose complete address in Canada is as the applicant's representative in Canada, pursuant to section 29 of the Patent Act.
6. The applicant appoints , whose complete address is , as the applicant's patent agent.
7. The applicant believes that in accordance with subsection 3.01(2) of the Patent Rules, the applicant is entitled to pay the fees at the small entity level in respect of this application. See instructions.
8. The applicant requests that Figure No. of the drawings accompany the abstract when it is open to public inspection under section 10 of the Patent Act or published.

(signature)

Text-only Version

---