ANNEX VIU.K.REQUEST OF CONVERSION OF A PROTECTED DESIGNATION OF ORIGIN INTO A GEOGRAPHICAL INDICATION
Date of receipt (DD/MM/YYYY) …U.K.
[to be completed by the Commission]
Number of pages (including this page) …
Language used for submission of application …
File number …
[to be completed by the Commission]
ApplicantU.K.
Name of legal or natural person …
Full address (street number and name, town/city and postal code, country) …
Legal status, size and composition (in the case of legal persons) …
Nationality …
Tel, fax, e-mail …
IntermediaryU.K.
Member State(s) (*)
Third-country authority (*)
[(*) delete as appropriate]
Name(s) of intermediary(ies) …
Full address(es) (street number and name, town/city and postal code, country) …
Tel, fax, e-mail …
Name to be registered …U.K.
Proof of protection in third country …
Product categories …U.K.
[on separate sheet]
Product specificationU.K.
Number of pages …
Name(s) of signatory(ies) …U.K.
Signature(s) …