Small Entity Declaration Form
Patent: ___________________________
Patent No. ___________________________
Applicant: ___________________________
The undersigned, on behalf of the applicant, hereby acknowledges and confirms having received the Miltons IP explanation of claiming Small Entity Status for the above-captioned patent application and/or having waived the receipt of this explanation.
The applicant believes that it is entitled to pay Canadian patent fees at the “small entity” level, as provided by Subsection 3.01(3) of the Patent Rules.
The undersigned, on behalf of the applicant, hereby instructs Miltons IP to claim Small Entity Status on behalf of the above-named applicant for the above-named patent application.
Name: ___________________________
Title: ___________________________
