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强制许可使用费数额裁决请求书(知识产权局2010版)

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<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.1//EN" "http://www.w3.org/TR/xhtml11/DTD/xhtml11.dtd"><html xmlns="http://www.w3.org/1999/xhtml"><head><meta http-equiv="Content-Type" content="application/xhtml+xml; charset=utf-8" /><title></title><style type="text/css">body{ font-family:'Times New Roman'; font-size:1em; } ul, ol{ margin-top: 0; margin-bottom: 0; } ins{color:#2E97D3;} del{color:#FF0000;} .Normal{page-break-inside:auto;page-break-after:auto;page-break-before:auto;margin-top:0.0pt;margin-bottom:0.0pt;margin-left:0.0pt;text-indent:0.0pt;border-top-style: none;border-left-style: none;border-right-style: none;border-bottom-style: none;font-size:12.0pt;font-family:'Times New Roman';mso-fareast-font-family:Calibri;mso-bidi-font-family:'Times New Roman';} .Heading-1{text-align:center;page-break-inside:avoid;page-break-after:auto;page-break-before:auto;margin-top:14.0pt;margin-bottom:14.0pt;margin-left:0.0pt;text-indent:0.0pt;border-top-style: none;border-left-style: none;border-right-style: none;border-bottom-style: none;color:#000000;font-size:18.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;font-weight:bold;} .Heading-2{text-align:center;page-break-inside:avoid;page-break-after:auto;page-break-before:auto;margin-top:14.0pt;margin-bottom:14.0pt;margin-left:0.0pt;text-indent:0.0pt;border-top-style: none;border-left-style: none;border-right-style: none;border-bottom-style: none;color:#000000;font-size:14.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;font-weight:bold;} .Default-Paragraph-Font{font-family:'Times New Roman';mso-fareast-font-family:Calibri;mso-bidi-font-family:'Times New Roman';} .Normal-Table{} .Normal--Web-{text-align:left;page-break-inside:auto;page-break-after:auto;page-break-before:auto;margin-left:0.0pt;text-indent:0.0pt;border-top-style: none;border-left-style: none;border-right-style: none;border-bottom-style: none;font-size:12.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;} .Table-Normal{} </style></head><body style="pagewidth:595.35pt;pageheight:841.95pt;"><div class="Section0"><div style="min-height:72pt" /> <p class="Heading-1"><span style="color:#000000;font-size:16.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;font-weight:bold;">强制许可使用费数额裁决请求书</span><span style="color:#000000;font-size:16.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;font-weight:bold;">&nbsp;</span></p> <table cellspacing="0" style="border-collapse: collapse; width: 433pt; "><tr style="height: 50.0px"><td rowspan="2" style="vertical-align:top;border-top-style:solid;border-top-color:#000000;border-top-width:1.0px;border-left-style:solid;border-left-color:#000000;border-left-width:1.0px;border-right-style:solid;border-right-color:#000000;border-right-width:1.0px;border-bottom-style:solid;border-bottom-color:#000000;border-bottom-width:1.0px;padding-left:0.5pt;padding-right:0.5pt;padding-top:0pt;padding-bottom:0pt;width:65px;"><p class="Normal--Web-" style="text-align:center;"><span style="color:#000000;font-size:12.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">①</span></p> <p class="Normal--Web-" style="text-align:center;"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">请</span></p> <p class="Normal--Web-" style="text-align:center;"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">求</span></p> <p class="Normal--Web-" style="text-align:center;"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">人</span></p> </td><td colspan="8" style="vertical-align:top;border-top-style:solid;border-top-color:#000000;border-top-width:1.0px;border-left-style:solid;border-left-color:#000000;border-left-width:1.0px;border-right-style:solid;border-right-color:#000000;border-right-width:1.0px;border-bottom-style:solid;border-bottom-color:#000000;border-bottom-width:1.0px;padding-left:0.5pt;padding-right:0.5pt;padding-top:0pt;padding-bottom:0pt;"><p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">姓名或名称                                </span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">电话     </span></p> </td></tr><tr style="height: 51.0px"><td colspan="8" style="vertical-align:top;border-top-style:solid;border-top-color:#000000;border-top-width:1.0px;border-left-style:solid;border-left-color:#000000;border-left-width:1.0px;border-right-style:solid;border-right-color:#000000;border-right-width:1.0px;border-bottom-style:solid;border-bottom-color:#000000;border-bottom-width:1.0px;padding-left:0.5pt;padding-right:0.5pt;padding-top:0pt;padding-bottom:0pt;"><p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">邮政编码                                    </span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">地址     </span></p> </td></tr><tr style="height: 50.0px"><td rowspan="2" style="vertical-align:top;border-top-style:solid;border-top-color:#000000;border-top-width:1.0px;border-left-style:solid;border-left-color:#000000;border-left-width:1.0px;border-right-style:solid;border-right-color:#000000;border-right-width:1.0px;border-bottom-style:solid;border-bottom-color:#000000;border-bottom-width:1.0px;padding-left:0.5pt;padding-right:0.5pt;padding-top:0pt;padding-bottom:0pt;width:65px;"><p class="Normal--Web-" style="text-align:center;"><span style="color:#000000;font-size:12.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">②</span></p> <p class="Normal--Web-" style="text-align:center;"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">联</span></p> <p class="Normal--Web-" style="text-align:center;"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">系</span></p> <p class="Normal--Web-" style="text-align:center;"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">人</span></p> </td><td colspan="8" style="vertical-align:top;border-top-style:solid;border-top-color:#000000;border-top-width:1.0px;border-left-style:solid;border-left-color:#000000;border-left-width:1.0px;border-right-style:solid;border-right-color:#000000;border-right-width:1.0px;border-bottom-style:solid;border-bottom-color:#000000;border-bottom-width:1.0px;padding-left:0.5pt;padding-right:0.5pt;padding-top:0pt;padding-bottom:0pt;"><p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">姓名                                </span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">电话     </span></p> </td></tr><tr style="height: 51.0px"><td colspan="8" style="vertical-align:top;border-top-style:solid;border-top-color:#000000;border-top-width:1.0px;border-left-style:solid;border-left-color:#000000;border-left-width:1.0px;border-right-style:solid;border-right-color:#000000;border-right-width:1.0px;border-bottom-style:solid;border-bottom-color:#000000;border-bottom-width:1.0px;padding-left:0.5pt;padding-right:0.5pt;padding-top:0pt;padding-bottom:0pt;"><p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">邮政编码                                    </span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">地址     </span></p> </td></tr><tr style="height: 46.399998px"><td rowspan="4" style="vertical-align:top;border-top-style:solid;border-top-color:#000000;border-top-width:1.0px;border-left-style:solid;border-left-color:#000000;border-left-width:1.0px;border-right-style:solid;border-right-color:#000000;border-right-width:1.0px;border-bottom-style:solid;border-bottom-color:#000000;border-bottom-width:1.0px;padding-left:0.5pt;padding-right:0.5pt;padding-top:0pt;padding-bottom:0pt;width:65px;"><p class="Normal--Web-" style="text-align:center;"><span style="color:#000000;font-size:12.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">③</span></p> <p class="Normal--Web-" style="text-align:center;"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">专</span></p> <p class="Normal--Web-" style="text-align:center;"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">利</span></p> <p class="Normal--Web-" style="text-align:center;"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">代</span></p> <p class="Normal--Web-" style="text-align:center;"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">理</span></p> <p class="Normal--Web-" style="text-align:center;"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">机</span></p> <p class="Normal--Web-" style="text-align:center;"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">构</span></p> </td><td colspan="5" style="vertical-align:top;border-top-style:solid;border-top-color:#000000;border-top-width:1.0px;border-left-style:solid;border-left-color:#000000;border-left-width:1.0px;border-right-style:solid;border-right-color:#000000;border-right-width:1.0px;border-bottom-style:solid;border-bottom-color:#000000;border-bottom-width:1.0px;padding-left:0.5pt;padding-right:0.5pt;padding-top:0pt;padding-bottom:0pt;"><p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">名称     </span></p> </td><td colspan="3" style="vertical-align:top;border-top-style:solid;border-top-color:#000000;border-top-width:1.0px;border-left-style:solid;border-left-color:#000000;border-left-width:1.0px;border-right-style:solid;border-right-color:#000000;border-right-width:1.0px;border-bottom-style:solid;border-bottom-color:#000000;border-bottom-width:1.0px;padding-left:0.5pt;padding-right:0.5pt;padding-top:0pt;padding-bottom:0pt;"><p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">机构代码     </span></p> </td></tr><tr style="height: 63.0px"><td rowspan="3" style="vertical-align:top;border-top-style:solid;border-top-color:#000000;border-top-width:1.0px;border-left-style:solid;border-left-color:#000000;border-left-width:1.0px;border-right-style:solid;border-right-color:#000000;border-right-width:1.0px;border-bottom-style:solid;border-bottom-color:#000000;border-bottom-width:1.0px;padding-left:0.5pt;padding-right:0.5pt;padding-top:0pt;padding-bottom:0pt;width:41.33333px;"><p class="Normal--Web-" style="text-align:center;"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">代</span></p> <p class="Normal--Web-" style="text-align:center;"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">理</span></p> <p class="Normal--Web-" style="text-align:center;"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">人</span></p> <p class="Normal--Web-" style="text-align:center;"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">(1)</span></p> <p class="Normal--Web-" style="text-align:center;"><span style="color:#000000;font-size:12.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;"> </span></p> <p class="Normal--Web-" style="text-align:center;"><span style="color:#000000;font-size:12.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;"> </span></p> </td><td style="vertical-align:top;border-top-style:solid;border-top-color:#000000;border-top-width:1.0px;border-left-style:solid;border-left-color:#000000;border-left-width:1.0px;border-right-style:solid;border-right-color:#000000;border-right-width:1.0px;border-bottom-style:solid;border-bottom-color:#000000;border-bottom-width:1.0px;padding-left:0.5pt;padding-right:0.5pt;padding-top:0pt;padding-bottom:0pt;width:75.13333px;"><p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">姓名</span></p> </td><td colspan="2" style="vertical-align:top;border-top-style:solid;border-top-color:#000000;border-top-width:1.0px;border-left-style:solid;border-left-color:#000000;border-left-width:1.0px;border-right-style:solid;border-right-color:#000000;border-right-width:1.0px;border-bottom-style:solid;border-bottom-color:#000000;border-bottom-width:1.0px;padding-left:0.5pt;padding-right:0.5pt;padding-top:0pt;padding-bottom:0pt;"><p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;"> </span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;"> </span></p> </td><td rowspan="3" style="vertical-align:bottom;border-top-style:solid;border-top-color:#000000;border-top-width:1.0px;border-left-style:solid;border-left-color:#000000;border-left-width:1.0px;border-right-style:solid;border-right-color:#000000;border-right-width:1.0px;border-bottom-style:solid;border-bottom-color:#000000;border-bottom-width:1.0px;padding-left:0.5pt;padding-right:0.5pt;padding-top:0pt;padding-bottom:0pt;width:34.6px;"><p class="Normal--Web-" style="text-align:center;"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">代</span></p> <p class="Normal--Web-" style="text-align:center;"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">理</span></p> <p class="Normal--Web-" style="text-align:center;"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">人</span></p> <p class="Normal--Web-" style="text-align:center;"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">(2)</span></p> <p class="Normal--Web-" style="text-align:center;"><span style="color:#000000;font-size:12.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;"> </span></p> <p class="Normal--Web-" style="text-align:center;"><span style="color:#000000;font-size:12.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;"> </span></p> </td><td style="vertical-align:top;border-top-style:solid;border-top-color:#000000;border-top-width:1.0px;border-left-style:solid;border-left-color:#000000;border-left-width:1.0px;border-right-style:solid;border-right-color:#000000;border-right-width:1.0px;border-bottom-style:solid;border-bottom-color:#000000;border-bottom-width:1.0px;padding-left:0.5pt;padding-right:0.5pt;padding-top:0pt;padding-bottom:0pt;width:58.6px;"><p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">姓名</span></p> </td><td style="vertical-align:top;border-top-style:solid;border-top-color:#000000;border-top-width:1.0px;border-left-style:solid;border-left-color:#000000;border-left-width:1.0px;border-right-style:solid;border-right-color:#000000;border-right-width:1.0px;border-bottom-style:solid;border-bottom-color:#000000;border-bottom-width:1.0px;padding-left:0.5pt;padding-right:0.5pt;padding-top:0pt;padding-bottom:0pt;width:92.4px;"><p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">     </span></p> </td></tr><tr style="height: 61.0px"><td style="vertical-align:top;border-top-style:solid;border-top-color:#000000;border-top-width:1.0px;border-left-style:solid;border-left-color:#000000;border-left-width:1.0px;border-right-style:solid;border-right-color:#000000;border-right-width:1.0px;border-bottom-style:solid;border-bottom-color:#000000;border-bottom-width:1.0px;padding-left:0.5pt;padding-right:0.5pt;padding-top:0pt;padding-bottom:0pt;width:75.13333px;"><p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">执业证号</span></p> </td><td colspan="2" style="vertical-align:top;border-top-style:solid;border-top-color:#000000;border-top-width:1.0px;border-left-style:solid;border-left-color:#000000;border-left-width:1.0px;border-right-style:solid;border-right-color:#000000;border-right-width:1.0px;border-bottom-style:solid;border-bottom-color:#000000;border-bottom-width:1.0px;padding-left:0.5pt;padding-right:0.5pt;padding-top:0pt;padding-bottom:0pt;"><p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">     </span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;"> </span></p> </td><td style="vertical-align:top;border-top-style:solid;border-top-color:#000000;border-top-width:1.0px;border-left-style:solid;border-left-color:#000000;border-left-width:1.0px;border-right-style:solid;border-right-color:#000000;border-right-width:1.0px;border-bottom-style:solid;border-bottom-color:#000000;border-bottom-width:1.0px;padding-left:0.5pt;padding-right:0.5pt;padding-top:0pt;padding-bottom:0pt;width:58.6px;"><p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">执业证号</span></p> </td><td style="vertical-align:top;border-top-style:solid;border-top-color:#000000;border-top-width:1.0px;border-left-style:solid;border-left-color:#000000;border-left-width:1.0px;border-right-style:solid;border-right-color:#000000;border-right-width:1.0px;border-bottom-style:solid;border-bottom-color:#000000;border-bottom-width:1.0px;padding-left:0.5pt;padding-right:0.5pt;padding-top:0pt;padding-bottom:0pt;width:92.4px;"><p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">     </span></p> </td></tr><tr style="height: 61.0px"><td style="vertical-align:top;border-top-style:solid;border-top-color:#000000;border-top-width:1.0px;border-left-style:solid;border-left-color:#000000;border-left-width:1.0px;border-right-style:solid;border-right-color:#000000;border-right-width:1.0px;border-bottom-style:solid;border-bottom-color:#000000;border-bottom-width:1.0px;padding-left:0.5pt;padding-right:0.5pt;padding-top:0pt;padding-bottom:0pt;width:75.13333px;"><p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">电话</span></p> </td><td colspan="2" style="vertical-align:top;border-top-style:solid;border-top-color:#000000;border-top-width:1.0px;border-left-style:solid;border-left-color:#000000;border-left-width:1.0px;border-right-style:solid;border-right-color:#000000;border-right-width:1.0px;border-bottom-style:solid;border-bottom-color:#000000;border-bottom-width:1.0px;padding-left:0.5pt;padding-right:0.5pt;padding-top:0pt;padding-bottom:0pt;"><p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">     </span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;"> </span></p> </td><td style="vertical-align:top;border-top-style:solid;border-top-color:#000000;border-top-width:1.0px;border-left-style:solid;border-left-color:#000000;border-left-width:1.0px;border-right-style:solid;border-right-color:#000000;border-right-width:1.0px;border-bottom-style:solid;border-bottom-color:#000000;border-bottom-width:1.0px;padding-left:0.5pt;padding-right:0.5pt;padding-top:0pt;padding-bottom:0pt;width:58.6px;"><p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">电话</span></p> </td><td style="vertical-align:top;border-top-style:solid;border-top-color:#000000;border-top-width:1.0px;border-left-style:solid;border-left-color:#000000;border-left-width:1.0px;border-right-style:solid;border-right-color:#000000;border-right-width:1.0px;border-bottom-style:solid;border-bottom-color:#000000;border-bottom-width:1.0px;padding-left:0.5pt;padding-right:0.5pt;padding-top:0pt;padding-bottom:0pt;width:92.4px;"><p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">     </span></p> </td></tr><tr style="height: 182.0px"><td colspan="9" style="vertical-align:top;border-top-style:solid;border-top-color:#000000;border-top-width:1.0px;border-left-style:solid;border-left-color:#000000;border-left-width:1.0px;border-right-style:solid;border-right-color:#000000;border-right-width:1.0px;border-bottom-style:solid;border-bottom-color:#000000;border-bottom-width:1.0px;padding-left:0.5pt;padding-right:0.5pt;padding-top:0pt;padding-bottom:0pt;"><p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">④ 根据专利法第57条的规定,请求对下述专利的使用费数额予以裁决。</span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">专利号</span><span style="color:#000000;font-size:12.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;text-decoration: underline;">        </span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">申请日</span><span style="color:#000000;font-size:12.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;text-decoration: underline;">    </span><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">年</span><span style="color:#000000;font-size:12.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;text-decoration: underline;">    </span><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">月</span><span style="color:#000000;font-size:12.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;text-decoration: underline;">    </span><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">日</span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;"> </span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">强制许可号</span><span style="color:#000000;font-size:12.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;text-decoration: underline;">        </span><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">专利权人</span><span style="color:#000000;font-size:12.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;text-decoration: underline;">        </span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;"> </span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">发明创造名称</span><span style="color:#000000;font-size:12.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;text-decoration: underline;">                    </span><span style="color:#000000;font-size:12.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;"> </span></p> </td></tr><tr style="height: 182.0px"><td colspan="9" style="vertical-align:top;border-top-style:solid;border-top-color:#000000;border-top-width:1.0px;border-left-style:solid;border-left-color:#000000;border-left-width:1.0px;border-right-style:solid;border-right-color:#000000;border-right-width:1.0px;border-bottom-style:solid;border-bottom-color:#000000;border-bottom-width:1.0px;padding-left:0.5pt;padding-right:0.5pt;padding-top:0pt;padding-bottom:0pt;"><p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">⑤请求裁决的理由:</span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">     </span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;"> </span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;"> </span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;"> </span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;"> </span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;"> </span></p> </td></tr><tr style="height: 130.0px"><td colspan="9" style="vertical-align:top;border-top-style:solid;border-top-color:#000000;border-top-width:1.0px;border-left-style:solid;border-left-color:#000000;border-left-width:1.0px;border-right-style:solid;border-right-color:#000000;border-right-width:1.0px;border-bottom-style:solid;border-bottom-color:#000000;border-bottom-width:1.0px;padding-left:0.5pt;padding-right:0.5pt;padding-top:0pt;padding-bottom:0pt;"><p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">⑥附件清单</span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">双方未能达成协议的证明文件</span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;"> </span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;"> </span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;"> </span></p> </td></tr><tr style="height: 118.0px"><td colspan="4" style="vertical-align:top;border-top-style:solid;border-top-color:#000000;border-top-width:1.0px;border-left-style:solid;border-left-color:#000000;border-left-width:1.0px;border-right-style:solid;border-right-color:#000000;border-right-width:1.0px;border-bottom-style:solid;border-bottom-color:#000000;border-bottom-width:1.0px;padding-left:0.5pt;padding-right:0.5pt;padding-top:0pt;padding-bottom:0pt;"><p class="Normal--Web-" style="text-align:right;"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">⑦请求人或专利代理机构签字或者盖章</span></p> <p class="Normal--Web-" style="text-align:right;"><span style="color:#000000;font-size:12.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;"> </span></p> <p class="Normal--Web-" style="text-align:right;"><span style="color:#000000;font-size:12.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;"> </span></p> <p class="Normal" style="text-align:right;"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">    年    月    日</span></p> </td><td colspan="5" style="vertical-align:top;border-top-style:solid;border-top-color:#000000;border-top-width:1.0px;border-left-style:solid;border-left-color:#000000;border-left-width:1.0px;border-right-style:solid;border-right-color:#000000;border-right-width:1.0px;border-bottom-style:solid;border-bottom-color:#000000;border-bottom-width:1.0px;padding-left:0.5pt;padding-right:0.5pt;padding-top:0pt;padding-bottom:0pt;"><p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">⑧国家知识产权局处理意见</span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;"> </span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;"> </span></p> <p class="Normal--Web-" style="text-align:right;"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">    年    月    日</span></p> </td></tr></table><p class="Heading-2"><span style="color:#000000;font-size:14.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;font-weight:bold;">注意事项</span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">一、本表应当使用中文填写,字迹为黑色,文字应当打字或印刷,提交一式一份。</span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">二、本表第①栏应当填写请求人的姓名或者名称以及详细地址;请求人为多人又未委托专利代理机构的,填写在第一栏的请求人为第一请求人,第一请求人为单位的还应当填写联系人姓名。</span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">三、本表第③栏应当填写经由国家知识产权局批准并在工商行政管理机关注册的专利代理机构名称,写明机构代码,专利代理机构指定的专利代理人不得超过两人,并注明专利代理人执业证号码。如果请求人是申请人或专利权人,第③栏中填写的专利代理机构信息应当与请求书中填写的内容一致,不一致的,应当办理著录项目变更手续。</span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">四、本表第④栏所填写的内容应当与该专利申请请求书中记载的内容一致。如果该专利办理过著录项目变更手续,应当按照国家知识产权局批准变更后的内容填写。</span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">五、本表第⑤栏,应当清楚扼要地叙述请求裁决的理由。该栏填写不下时,应当使用规定格式的附页续写。</span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">六、第⑥栏中的方格供填表人选择使用,若有方格后所述情况的,应当在方格内作标记。</span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">七、本表第⑦栏,委托专利代理机构的,应当由专利代理机构加盖公章。未委托专利代理机构的,请求人为个人的应当由本人签字或者盖章;请求人是单位的应当加盖单位公章;有多个请求人的由第一请求人签字或者盖章。</span><span style="color:#000000;font-size:12.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">&nbsp;&nbsp;&nbsp;</span><span style="color:#000000;font-size:12.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">&nbsp;&nbsp;</span><a id="_GoBack" /></p> </div></body></html>

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