Legal PCT Form

LEGAL PCT FORM

This Power of Attorney and Request for International Filing under the Patent Cooperation Treaty (PCT) is made as of Date: by and between Applicant Name: (hereafter "Applicant") and Agent/Representative Name: (hereafter "Agent").

RECITALS

WHEREAS, Applicant is the legal or beneficial owner of the invention titled "" and desires to seek protection by filing an international patent application under the Patent Cooperation Treaty;

WHEREAS, Applicant has instructed Agent to prepare, file and prosecute an international application on Applicant's behalf, and Agent is authorized to act as Applicant's representative before international receiving and designated offices, subject to the terms and limitations set forth herein;

WHEREAS, Applicant and Agent desire to set forth their respective authorities, obligations, and the scope of representation with respect to the PCT filing identified below.

NOW, THEREFORE

In consideration of the mutual covenants contained herein, the parties agree as follows:

1. INTERNATIONAL APPLICATION DETAILS

1.1 International Application Title:

1.2 International Filing Date (if known):

2. APPOINTMENT AND SCOPE

2.1 Appointment. Applicant hereby appoints Agent and any registered representatives within Agent's firm as Applicant's true and lawful agent and attorney-in-fact to prepare, sign, file, prosecute and otherwise conduct all necessary acts in connection with the preparation and filing of an international application under the PCT, including the signing of necessary forms, payment of routine fees to the extent authorized under Section 3, and receipt of correspondence related to the application.

2.2 Scope of Authority. The authority granted includes, without limitation, the authority to: (a) file the international application as specified herein; (b) amend or correct the application to comply with formal requirements and procedural rules; (c) appoint local associates or agents in foreign jurisdictions if and as necessary for national phase entry; and (d) make such procedural elections and selections as Agent deems reasonably necessary to preserve Applicant's rights, subject to Applicant's prior instructions where such instructions have been given.

3. REPRESENTATIONS, FEES, AND PAYMENT

3.1 Applicant represents that it has the right to file the application and that the information furnished to Agent is complete and accurate to the best of Applicant's knowledge. Applicant agrees to notify Agent promptly of any changes to inventorship, ownership, or other material facts.

3.2 Fees. Applicant authorizes Agent to charge and Applicant shall pay Agent's filing, preparation, correspondence, translation and other professional fees as invoiced. Applicant further authorizes payment of official fees on Applicant's behalf upon prior written or electronic approval as provided in Section 11 (Notices).

4. CONFIDENTIALITY AND DOCUMENTS

4.1 Confidentiality. Agent shall treat all non-public information and documents received from Applicant as confidential and shall not disclose such information except as required to perform the duties under this Form, as required by law, or upon Applicant's instruction.

4.2 Documents. Unless otherwise agreed, original documents and executed instruments submitted to Agent in connection with the international application will be retained by Agent for the period required by applicable rules and will be returned to Applicant upon written request and settlement of outstanding fees.

5. TERMINATION

5.1 Termination. This appointment may be terminated by either party upon thirty (30) days' prior written notice to the other party; provided, however, that termination shall not relieve Applicant of liability for fees and expenses incurred prior to the effective date of termination, nor shall termination prejudice Agent's right to take such steps as are required to protect pending rights in accordance with applicable rules.

6. INDEMNIFICATION AND LIMITATION OF LIABILITY

6.1 Indemnification. Applicant agrees to indemnify and hold Agent and its representatives harmless from and against any losses, liabilities, costs or expenses (including reasonable attorneys' fees) arising out of Applicant's breach of representations or failure to provide complete or accurate information necessary for prosecution of the application.

6.2 Limitation of Liability. Except in the case of willful misconduct or gross negligence, Agent's liability for any act or omission in connection with this appointment is limited to direct damages not to exceed the total fees paid to Agent in connection with the matter giving rise to the claim.

7. NOTICES

7.1 All notices under this Form must be in writing and shall be delivered by hand, overnight courier, or electronic mail (with confirmation of transmission) to the correspondence addresses set forth in Section 3. Notices shall be effective upon receipt.

8. AMENDMENTS; WAIVER; COUNTERPARTS

8.1 Amendment. No amendment or modification of this Form shall be effective unless in writing and signed by both parties.

8.2 Waiver. No waiver of any breach shall be effective unless executed in writing by the party granting the waiver.

8.3 Counterparts. This Form may be executed in counterparts, each of which shall be deemed an original and all of which together shall constitute one instrument.

9. GOVERNING LAW; ENTIRE AGREEMENT; SEVERABILITY

9.1 Governing Law. This Form shall be governed by and construed in accordance with the substantive laws selected by the parties: , without regard to conflict of law principles.

9.2 Entire Agreement. This Form constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior and contemporaneous agreements, whether oral or written.

9.3 Severability. If any provision of this Form is held invalid or unenforceable, such provision shall be severed and the remaining provisions shall remain in full force and effect.

10. MISCELLANEOUS

10.1 Further Assurances. Each party shall execute and deliver such further documents and do such further acts as may be reasonably necessary to carry out the purposes of this Form.

CERTIFICATIONS

Applicant certifies that the information provided in connection with the international application is true and complete to the best of Applicant's knowledge. Applicant authorizes Agent to rely upon such certifications and to act in reliance thereon.

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