Fee Payment Form

Protected B when Complete

Office Use Only



CIPO Fee Payment Form
(PDF - 1.2 MB - 2 pages)

Disclaimer

This form must only be used to provide financial information concerning the fee payment method as well as other information that will assist CIPO's Finance Branch in correctly processing your payment. Any substantive information, such as information concerning the purpose for which these fees are paid or information concerning the prosecution of an application, must be submitted in a separate document (such as covering correspondence). Information submitted in this form is not considered to form part of the substantive file relating to an application or any other procedure. CIPO does not make this information available for public inspection.

Privacy Statement: The information collected on this form is stored in Personal Information Bank #IC-PPU-079. Any personal information collected on this form is protected under the provisions of the Privacy Act and the Access to Information Act. These Acts provide you with the right to protect and to access your personal information. To submit a personal information request, please visit the Infosource Website

Fee Payment Form Instructions

Section 1: Fee Type or Deposit Account Replenishment (only one selection)

Patent
Patent Appeal Board
Trade-mark
Trade-marks Opposition Board
Copyright
Industrial Design
Copy/Certified Copy
Integrated Circuit Topography

Deposit Account Replenishment

Deposit Account Number

Section 2: Application/Registration/Patent Information

Application/Registration/ Patent Number

Client Reference Number

Listing Attached

Purpose of Payment

Section 3: Contact Information for Method of Payment

Surname

Given Name

Company/Firm Name

Address

City

Province/Territory

Postal Code

Telephone Number

Fax Number

Email Address

Section 4: Payment Details — Method of Payment

Credit Card

VISA

MasterCard

American Express

Cheque / Money Order

Reference Number

Deposit Account

Deposit Account Number

Wire Transfer

Credit Card Account Number

Card Identification Number

Expiry Date (mm/yyyy)

Name as it Appears on Credit Card

Amount Paid (CAD)
$

Section 5: Payment Details — Alternate Method of Payment (optional)

Credit Card

VISA

MasterCard

American Express

Deposit Account

Deposit Account Number

Credit Card Account Number

Card Identification Number

Expiry Date (mm/yyyy)

Name as it Appears on Credit Card

Amount Paid (CAD)
$

CIPO0240E (2009/01)

Canada

Date


Fee Payment Form Instructions

If sending the Fee Payment Form and covering correspondence by facsimile, please do not submit a hard copy by mail. This could result in a duplicate payment.

To submit all documents to the Commissioner of Patents (regarding patents and industrial designs), the Registrar of Trade-marks, the Copyright Office or the Registrar of Topographies, please use only this facsimile number: 819-953-CIPO (2476). To submit all documents to the Trademarks Opposition Board, please use: 819-997-5092. By mail: Place du Portage I, 50 Victoria St., Room C-114, Gatineau, Quebec K1A 0C9.

Please note that the Canadian Intellectual Property Office (CIPO) will not speculate as to which fee the payment is intended to cover. If the client's intention is unclear, CIPO may not process the fee payment. Therefore, it is the client's responsibility to provide CIPO with as much information as possible with regard to the fee payment submitted.

It is the client's responsibility to ensure that sufficient funds are available to cover all fee payments. If such is not the case and an alternate method of payment has been indicated, CIPO will attempt to withdraw the funds from the methods of payment in the order in which they appear on the form. If the funds are insufficient, the payment may not be processed.

For more information on CIPO fees, please refer to the current fee schedule. To request a paper copy by mail, contact the CIPO Client Service Centre at 1-866-997-1936.

General Authorization
Should a client wish to include a general authorization in the covering correspondence submitted by mail, facsimile or hand-delivery, please refer to the Practice Notice entitled Fee Payment: General Authorization to Charge a Deficiency.

Protecting Your Credit Card Information
CIPO strongly recommends using the Fee Payment Form for credit card payments submitted by mail, facsimile, or hand-delivery. To protect your credit card details, only use the Fee Payment Form to communicate this information and do not include payment information on any other form or document that you send to CIPO. Do not submit this form by email. Credit card information for online credit card payments should be entered exclusively using one of the electronic filing services with electronic payment capability provided on CIPO's website.


How to Complete the Form

Section 1: Fee Type or Deposit Account Replenishment
Please check only one box indicating the fee type or, if you wish to replenish your deposit account, check the box for that purpose and enter your account number.

Section 2: Application/Registration/Patent Information
Include all unique identifying numbers in order to help CIPO match your payment, covering correspondence and/or listing with this Fee Payment Form. If your payment relates to a single application, registration or patent, please complete the following fields as instructed below. If your payment relates to multiple applications, registrations or patents, please check the Listing Attached box and submit the listing with the form. If your payment is to replenish your deposit account, you may leave this section empty and complete Sections 3 to 5.

Application/Registration/Patent Number: If your payment relates to an application for a patent, trade-mark, copyright, industrial design or integrated circuit topography, enter the application number. If your trade-mark, copyright, industrial design or integrated circuit topography is already registered, provide the registration number. If your payment relates to an already issued patent, enter the patent number.

Client Reference Number: This is the reference number provided by your company/firm. This number should also be included in the covering correspondence.

Purpose of Payment: To assist CIPO in processing your payment, please indicate clearly the purpose for which you are providing payment. For more information on CIPO fees, please refer to the current fee schedule. Please note that any substantive information, such as information concerning the purpose for which the fee is paid or information concerning the prosecution of an application, must also be submitted in a separate document (such as covering correspondence). Information submitted in this form is not considered to be part of the substantive file relating to an application or any other procedure. CIPO does not make this information available for public inspection.

Section 3: Contact Information for Method of Payment
In order to ensure that CIPO is able to effectively communicate with you, please ensure that this section is completed in full. Please note that some legislation restricts who can correspond with the Office. Therefore, the name of the company/firm should be clearly mentioned. Please check the applicable legislation for further information.

Section 4: Payment Details — Method of Payment
Please check only one box for the method of payment: credit card, cheque / money order, deposit account or wire transfer. Complete the appropriate fields for the payment method selected.

Credit Card: Enter all necessary credit card information, including the payment amount to be charged to your credit card. CIPO cannot process credit card payments without all the required information (i.e., credit card number, name of cardholder, expiry date, card identification number). For MasterCard or VISA, the card identification number (also called the card verification value) is the three digit number located on the back of the card, while American Express cards list a four digit number on the front of the card.

Cheque / Money Order: Enter the cheque or money order serial/reference number in the Reference Number field.
Deposit Account: Enter the deposit account number in the Deposit Account Number field.
Wire Transfer: No additional fields are required. Simply check the appropriate box and attach the relevant information.

Section 5: Payment Details — Alternate Method of Payment
This section is to be used at your discretion if you believe a second method of payment may be required to ensure that sufficient funds be available to cover the full payment. Alternate payments can only be made by credit card or deposit account. Please refer to the instructions in Section 4 in order to ensure that this information is properly provided to CIPO.