我/我們是_____的公民/法人，根據(jù)中華人民共和國(guó)專利法第19條的規(guī)定，茲委托_____ (機(jī)構(gòu)代碼：__________)，并由該機(jī)構(gòu)指定其專利代理人_____、_____代為辦理名稱為_(kāi)______________申請(qǐng)?zhí)?或?qū)＠��?hào))/國(guó)際申請(qǐng)?zhí)枮開(kāi)____的專利申請(qǐng)?jiān)谥腥A人民共和國(guó)的全部專利事宜。

　　Pursuant to the Article 19 of the Patent Law of the People’s Republic of China, I/we, citizen/legal entity of_____hereby authorize _____ (Code:_____) to appoint its patent attorney(s)_____ ，_____ to handle all patent affairs related to the application with title as_____ and application number(or patent number)/international application number as_____in the PRC.

　　委托人姓名或名稱

　　Authorized by (Name)

　　_________

　　委托人簽字或蓋章

　　Signature or Seal

　　__________

　　被委托專利代理機(jī)構(gòu)蓋章

　　Seal of the Authorized Agent

　　__________

　　委托日期

　　Date of Authorization

　　__________