New Client Information Form | Murgitroyd, European Patent & Trade Mark Attorneys

Who is completing the form?
Name
Title First Name Last Name
Contact Email
General Contact Information For Your Business:
Business Name
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Business Phone
Business Email
Website
Your Company Demographics
Services We Are Providing To You
- Docketing
- US Managed Services
- Trade Mark Clearance Search
- Trade Mark Watching
- IDS Filing
- PCT Filing
- Trade Mark Foreign Filing and Prosecution
- Design Foreign Filing
- Patent Foreign Filing (Handback)
- Licensing
- Patent Foreign Filing and Prosecution
- Trade Mark Renewals
- Patent Renewals
- Patentability Searching
- Invalidity Searching
- Technical Illustration
- Translations
- EP Validation
- Oppositions
- US Managed Services
Your sector
- High-Tech and Software
- Life Sciences, Chemistry and Pharmaceuticals
- Mechanical Engineering
- Energy
- Consumer Goods
- Business and Financial Services
- Creative Industries
- Other
How many locations do you have worldwide?

What countries are these offices located?

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Correspondence Contact
Our default is to send all correspondence via email except for original certificates of grant. If you need this to be different, please note this under “special instructions below”.
Correspondence Contact Name
Title First Name Last Name
Job Title
Email
Where To Send - Physical Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Would you like copies sent to anyone?
- Yes
- No
If 'Yes', who?
Do you want Murgitroyd to be responsible for monitoring and payment of renewals?
- Yes
- No
Renewals Contact Name
Title First Name Last Name
Email
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
If powers of attorney documents are required, do you want to execute general or specific power of attorney documents?
- General
- Specific
Would you like access to our Client Portal?
- Yes
- No
If 'Yes', who needs access?

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Accounting Contact
Accounts Physical Mailing Address:
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Attention to:
Title First Name Last Name
Email
Phone
Accounts Special Instructions:
Invoicing Type and Contact
Please state the main currency in which you would like your invoices issued:
Type of Invoices Requested:
- Individual
- Monthly Consolidated
- Electronic - e-billing platform upload
Specify electronic - e-billing platform used*
Name of electronic e-billing platform used*
Please provide billing system info
Contact for billing system
Title First Name Last Name
Phone
Email
Do you require a PO No. on your invoices?
- Yes
- No
If YES, please provide the contact information for who assigns this PO #:
Title First Name Last Name
Phone
Email
Attention to on Invoice:
Title First Name Last Name
Phone
Email
Special invoicing instructions
Is the person above also responsible for actual payment of invoices?
- Yes
- No
Who is responsible for actual payment of invoices?
Title First Name Last Name
Phone
Email

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Accounts & Invoicing cont.
Murgitroyd sends an electronic statement each month to all clients showing current outstanding invoices.
Where would you like the Statement of Accounts to be sent?
Title First Name Last Name
Phone
Email
In the event an invoice becomes overdue who would you like us to contact (if different from above)?
Title First Name Last Name
Phone
Email
Please forward a full remittance advice to us with all your payments to accounts@murgitroyd.com.
Do you need us to complete a supplier registration form and/or any tax forms (W-8BEN form, etc.)?
- Yes
- No
If YES, please forward a copy to creditcontrol@murgitroyd.com.
If you wish to query an invoice, please contact creditcontrol@murgitroyd.com.
Any further information you would like to provide?

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Name
{Name:1}

Phone
{Phone:3}

Email
{Email:2}

Nationality
{Nationality:12.6}

Work Permit
{Do you need a work permit to work in the UK?:42}

Position of Interest
{Position of Interest:14}

Specialisation
{Specialisation:15}

Preferred Location
{Preferred Location:16}

Personal Statement
{Personal Statement:17}

Qualifications
{Qualifications:18}

Current Employment
{Current Employement:19}

Work Experiences, Training & Skills
{Work Experiences, Training & Skills:20}
Special Requirements*
Personal Data*
- I accept that any personal data shared with us in this process will be processed in accordance with our Data Protection Policy.
Declaration*
- By ticking this box you confirm that the information given in this application form is true and complete. You understand that if you have given any misleading information on this form or made any omissions, this will be sufficient grounds for rejection.
Email
This field is for validation purposes and should be left unchanged.

Who is completing the form?