Regulation on the entry of varieties into the List of Varieties

1. Podnositelj zahtjeva Annlicant lme (First name): Prezime (Last name): Poslovni subjekt: (Organisation): Adresa: (Address) : Postanskj broj (ZIP code): Mjesto (Place): Drzava (Country): OIB poslovnog subjekta (VAT number): Telefon (Phone Nr.): Telefaks (Fax Nr.): E-mail (e-mail):

2. Punomocnik podnositelja zahtjeva sorte (Uz zahtjev priloiite punomoc o zastupanju u postupku priznavanja sorti poljoprivrednog bilja) Procedural representative ofthe applicant and the maintainer ofthe variety (Please attach the completed form ofthe authorization ofthe vrocedural revresentative) Ime (First name): Prezime (Last name): Poslovni subjekt: (Organisation): Adresa: (Address): Postanski broj (ZIP code).- Mjesto (Place): Drzava (Country) : OIB poslovnog subjekta (VAT number): Telefon (Phone Nr.): Telefaks (Fax Nr.): E-mai l (e-mail):

3. Oplemenjivac/i so rte (The original breeder(,;;) ofthe variety) □ Oplemeoj ivac so rte je podoositeij zabtjeva (breeder of variety is applicant) D Oplemenj ivac sorte nije podnositelj zahtjeva (breeder of variety is NOT applicant) Ovlemeniivac I Breeder 1 Ovlemeniivac 2 Breeder 2 Ime (First name): Ime (First name): Prezime (Last name): Prezime (Last name) : Poslovni subjekt: (Organisation): Poslovni subjekt: (Organisation): Adresa: (Address) : Adresa: (Address): Postanski broj (ZIP code) · Mjesto (Place) : Postanski broj (ZIP code) : Mjesto (Place) : Drzava (Country): Drzava (Count1y) : OIB poslovnog subjekta. (VAT number): OIB poslovnog subjekta (VAT number): Telefon (Phone Nr.): Telefon (Phone Nr.): Telefaks (Fax Nr.) : Telefaks (Fax Nr.) : E-mai l (e-mail): E-mail (e-mail):

4. Odrzivac sorte Mailltainer Ime (First name): Prezime (Last name): Poslovoi subjekt: (Organisation): Adresa: (Address): Postanski broj (ZIP code): Mjesto (Place): Drzava (Country): OIB poslovoog subjekta (VAT number).· Telefoo (Phone Nr.): Telefaks (Fax Nr.): E-mail (e-mail) :

5. Punomocnik odrzivafa sorte (Uz zahtjev prilozite punomoc o zastupanju u postupku odrzavanja sorti poljoprivrednog bilja) Procedural representative ofthe aoolicant and the maintainer of the variety (As my procedural representative in respect ofmaintenance o variety) Ime (First name): Prezime (Last name): Poslovni subjekt: (Organisation) : Adresa: (Address) : Postanski broj (ZIP code): Mjesto (Place): Drzava (Country): OTB poslovnog subjekta (VAT number): Telefon (Phone Nr.): Telefaks (Fax Nr.): E-mai l (e-mail):

6. Vrsta kojoj sorta pripada Species to which the variety belongs Latinsko ime vrste (Latin name): _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Hrvatsko ime vrste (Croatian name): _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ 7. lme sorte I denominacija (upotrebljavajte velika i ma/a slova) Variety denomination (using capital and little letters) Oplemeojivacka oznaka (Breeders ref erence): Predlozeno ime sorte (Proposed name of the variety) :_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

8. Predlozeno ime sorte je (Proposed designation is) D Zamisljeno ime (Fancy name) □ Kod (Code)

9. Podaci o upisu sorte na sortnu listu i oplemenjivacko pravo sorte Information regarding national listing and plant breeder's rights ofthe variety □ Sorta je prijavljena iii je upisana na sortnu listu u drugoj drzavi (The variety has been avvlied or has been listed to the National Variety list in any other country) Drzava (Country) Irne iii predlozeno irne sorte U postupku upisa Upisana (Variety denomination) (Annlication oendinf!) (Alreadv listed) □ □ □ □ □ □ □ Sorta nije upisana i nije prijavljena za upisivanje na sortnu listu u niti jednoj drugoj drzavi (The variety has N OT been listed and not applied for National variety list in any other counliy)

10. Podaci o zastiti sorte (The variety protection data) □ Sorta je zasticena u drugoj/irn drzavi/arna, navedite u kojoj/irn i godinu zastite (The variety has been protected in other countries, in which countries and year ofprotection): □ Sorta nije zasticena niti u jednoj drzavi (The variety has NOT been protected in other country) ll. Postupak ispitivanja razlicitosti, ujednacenosti i postojanosti (DUS) Technical examination ofthe variety (DUS) D je zavrsen, navedite drfavu/e (has already been completed, give the country): _____________ D se trenutno provodi, navedite drfavu/e (is conducted, give the country): _______________ D nije proveden (has not been done), □ ovim zahtjevom trazimo provodenje DUS ispitivanja u (navedite drfavu): _ _ _ _ _ _ _ _ _ _ _ _ __ (with this Application, we request the conduct ofa DUS examination in (specify the country))

12. Sorta je stvorena uz pomoc genetske tebnologije iii sadrzi genetski modificirane organizme The variety is or includes genetically modified organisms (GMO) □ DA (Yes) □ NE(No) Ako DA, prilozite dozvolu za pustanje GMO u okolinu. ( In case of YES enclose premission to release GMO into the environment)

13. Zemlja u kojoj je sorta stvorena iii otkrivena i razvijena: (The country in which the variety was breed or discovered and developed:)

14. Upotreba so rte (Use ofthe variety)

15. Mj esto (adresa) odriavanja sorte: (Locality (adress), where the variety maintenance takes place:) U Republici Hrvatskoj U drugoj zernlji clanici ili trecoj zernlji, kojoj je Europska (in the Republic of Croatia) komisija priznala istovjetnost za odrzavanje sorte {in other Member States or third countries, afforded the same ~uarantees as those carried out by the MS)

16. Prilozi (Enclosures) D tehnicki upitnik {Technical Questionnaire) D punomoc za zastupanje (Authorization ofthe Representative) □ izvjesce o DUS testiranju (DUS Test Report) □ dozvola za pustanje GMO-a u okolinu (Permission for releasing GMO in to environment) □ ostalo, navedite priloge (other, specify):

17. Izjava (Statement) Prijavljuj em se za postupak priznavanja sorti poljoprivrednog bilja Repub like Hrvatske (I apply for addition to the National Variety List in the Republic ofCroatia.) lzjavlj ujem da su svi podaci u prijavi i prilozima potpuni i tocni (1 declare that all data stated in the application and attachmentsare, to the best ofmy knowledge, complete and correct). Suglasan/a sam da se Zavod moze savj etovati i izmjeniti podatke sa drugim sortnim uredima (1 agree that, the Administration may consult and exchange data with other variety offices). Izjavlj ujem da cu platiti sve troskove i pristoj be u postupku priznavanja sorti poljoprivrednog bilja u predvidenim rokovima. (I agree to pay all the costs and fees variety addition to the National Variety List). Mjesto:_ _ _ _ __ Datum:- - - - - - (Place): (Date): Potpis i pecat podnositelja zahtjeva:_ _ _ _ _ _ _ _ _ _ _ _ __ (Signature and stump of the person entitled): M.P. Obrazac 2. (Form 2) ZAHTJEV ZA PRIZNAVANJE CUVANE SORTE ILi SORTE RAZ VIJENE ZA UZGOJ PRI ODREDENIM UVJETIMA Mjesto za naljepnicu klase i ur. broja Application for Addition of conservation variety or variety developed for growing under particular condition to the List of Varieties of the Republic of Croatia

1. Podnositelj zahtjeva Anolicant Ime (First name): Prezime (Last name): Poslovni subjekt: (Organisation) : Adresa: (Address): Postanski broj (ZIP code): Mjesto (Place): Drzava (Country) : OIB poslovnog subjekta (VAT number): Telefon (Phone Nr.): Telefaks (Fax Nr.): E-mail (e-mail):

2. Odrzivac sorte 111aintainer lme (First name): Prezime (Last name): Poslovni subjekt: (Organisation): Adresa: (Address): Postanski broj (ZIP code): Mjesto (Place).- Drzava (Country): OIB poslovnog subjekta (VAT number): Telefon (Phone Nr.): Telefaks (Fax Nr.) : E-mail (e-mail):

3. Vrsta kojoj sorta pripada Species to which the variety belongs Latinsko ime vrste (Latin name):_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Hrvatsko ime vrste (Croatian name):_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

4. Ime sorte / denominacija (upotrebljavajte velika i mala slova) Variety denomination (using capital and little letters) Predlozeno ime sorte (Proposed name of the variety):_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

5. Predlozeno ime sorte je (Proposed designation is) D Zamisljeno ime (Fancy name) D Kod (Code)

6. Mjcsto (adrcsa) odrfavanja sortc (Locality (adres~), where the variety maintenance takes place)

7. Regija podrijetla u kojoj sc cuvana sorta tradicionalno uzg.ajala i cijim je lokalnim i regionalnim uvjetima prirodno priJagodena (samo za cuvane sorte) (Region oforigin in which the variety has historically been gro,vn and to which it is naturally adapted - only for conservation variety)

8. Informacija o brisanju sorte sa Sortne liste iii sa Zajednickog kataloga sorata Europskc unije (Informati on on the variety deletion from the National list or from the Common Catalof(ue) Datum brisanja sa Nacionalne liste Datum brisanja sa Zajednickog kataloga Date ofdeletion from NLI Date ofdeletion from CC

9. Izjavljujem da sorta nije zasticena oplemenjivackim pravom Europske unije iii nacionalnim oplcmenjivackim pravom niti je podnesen zahtjev za takvu zastitu (I hereby declare that the variety is neither applied for protection nor protected by the National or Community Plant Breeder's Right)

10. Upotreba sorte (Use of.the variety) □ Cuvana sorta/domaca i udomaccna sorta (Conservation variety) □ Sorta razvijena za uzgoj pri odredenim uvjetima (Variety developed for growing under particular conditions)

11. Prilozi (Enclosures) □ tehnicki upitnik (Technical Questionnaire) □ izvjcscc o DUS testiranju (DUS Test Report) □ dozvola za pustanje GMO-au okolinu (Permission for releasing GMO in to environment) D ostalo, navedite priloge (other, specify):

12. Sorta je stvorena uz pomoc genetske tehnologije ili sadrzi genetski modificirane organizme The variety is or includes genetically modified organisms (GMO) D DA (Yes) □ NE (No) Ako DA, prilozite dozvolu za pustanje GMO u okoliou. ( Jn case of YES enclose premission to release GMO into the environment) 13. lzjava (Statement) Prijavljujem se za postupak priznavanja cuvane sorte odnosoo sorte razvijeoe za uzgoj pri odredeoim uvj etiroa Republike Hrvatske (I apply for addition to the Variety List) Izjavljujern da su svi podaci u prijavi i prilozima potpuoi i tocoi (I declare that all data stated in the application and attachments are, to the best of my knowledge, complete and correct). Suglasan/a sam da sc Agcncija moze savjctovati i izmjeniti podatkc sa drugim sortnim uredima (I agree that, the Administration may consult and exchange data with other variety offices). Mjesto: _ _ _ _ __ Datum:_ _ _ _ __ (Place) .· (Date) · Potpis i pecat podDositelja zabtjeva: _ _ _ _ _ _ _ _ _ _ _ _ __ (Signature and stump ofthe person entitled): M.P. Obrazac 3. (Form 3) ZAHT JEV ZA UPIS SORTE U NACIONALNU SORTNU LISTU Mjesto za naljepnicu klase i ur. broja Application for Addition to the National Variety List

1. Podnositelj zahtjeva Annlica11t Ime (First name): Prezime (Last name): Poslovnj subjekt: (Organisation): Adresa: (Address): Postanski broj (ZIP code): Mjesto (Place) : Drzava (Country): OTB poslovnog subjekta (VAT number): Telefon (Phone Nr.): Telefaks (Fax Nr.): E-mail (e-mail):

2. Odriivac sorte Maintai11er lme (First name): Prezime (Last name): Poslovni subjekt: (Organisation): Adresa: (Address) : Postanski broj (ZIP code): Mjesto (Place): Drzava (Country): OIB poslovnog subjekta (VAT number): Telefon (Phone Nr.) : Telefaks (Fax Nr.): E-mail (e-mail):

3. Vrsta kojoj sorta pripada Species to which the variety belo11gs Latinsko ime vrste (Latin name): _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Hrvatsko ime vrste (Croatian name): _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ 4. lme sorte I denominacija (upotrebljavajte velika i mala slova) Variety de11omination (using capital and little letters) Predlozeno ime sorte (Proposed name ofthe variety): _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

5. Mjesto (adresa) odriavanja sorte (Locality (adress), where the variety maintenance takes place)

6. Rcgija podrijctla u kojoj sc sorta tradicionalno uzgajala i cijim jc lokalnim i rcgionalnim uvjctima prirodno prilagodcna (Region oforigin in which the variety has historically been grown and to which it is naturally adapted) 7. lzjavljujem da sorta nije zasticena oplemenjivackim pravom Europske unije iii nacionalnim oplemenjivackim pravom niti je podncscn zahtjev za takvu zastitu (I hereby declare that the variety is neither applied for protection nor protected by the National or Community Plant Breeder's Right)

8. Upotreba sorte (Use ofthe variety)

9. Sorta je stvorena uz pomoc genetske tehnologije iii sadrzi genetski modificirane organizme The variety is or includes genetically modified organisms (GMO) □ DA (Yes) □ NE (No) Ako DA, prilozite dozvolu za pustanje GMO u okolinu. ( In case of YES enclose premission to release GMO into the environment)

10. Prilozi (Enclosures) D kratki morfoloski opis so rte popra6cn fotodokumcntacijom (short morphological description ofthe variety accompanied by photo documentation) □ znanja stecena kroz prakticno iskustvo tijekom uzgoja, razmnozavanja i koristenja (knowledge acquired through practical experience during cultivation, reproduction and use) □ tehnicki upitnik (Technical Questionnaire) □ dozvola za pustanje GMO-au okolinu (Permission for releasing GMO in to environment) □ ostalo, navedite priloge (other, specify): 1l. Izjava (Statement) Prijav ijujem se za postupak upisa sorte u Nacionalnu sortnu listu (I apply for addition to the National Variety List) Izjavljuj em da su svi podaci u prijavi i prilozima potpuni i tocni (I declare that all data stated in the application and attachments are, to the best ofmy knowledge, complete and correcl). Suglasan/a sam da sc Agcncija mozc savjetovati i izmjeniti podatkc sa drugim sortnim uredima (I agree that, the Administration may consult and exchange data with other variety offices). Mjesto:_ _ _ _ __ Datum:_ _ _ _ __ (Place).' (Date): Potpis i pecat podnositelja zahtjeva:_ _ _ _ _ _ _ _ _ _ _ _ __ (Signature and stump of the person entitled): M.P. Obrazac 4. (Form 4) ZAHTJEV ZA OBNA VLJANJE UPISA SORTE U SORTNU LISTU REPUBLIKE HRVATSKE Mjesto za naljepnicu klase i ur. broja Application for Renewal ofRegistration to the List of Varieties ofthe Republic of Croatia

1. Podnositelj zahtj eva Annlicant lme (First name): Prezime (Last name): Poslovni subjekt: (Organisation): Adresa: (Address) : Postanski broj (ZIP code): Mjcsto (Place): Drzava (Country) : OIB poslovnog subjekta (VAT number): Telefon (Phone Nr.) • Telefaks (Fax Nr.). E-mail (e-mail):

2. Punomocnik podnositelja zahtjeva i odrzivaca sorte (Uz zahtjev priloiite punomoc o zastupanju u postupku priznavanja sorti poljoprivrednog bilja) Procedural represe11tative of the applicant and the maintainer ofthe variety (Please attach the completed form ofthe authorization ofthe vrocedural revresentative) Tme (First name): Prezime (Last name): Poslovni subjekt: (Organisation): Adresa: (Address) : Postanski broj (ZIP code): Mjesto (Place) : Drzava (Counlly): OIB poslovnog subjekta (VAT number): Telefon (Phone Nr.) • Telefaks (Fax Nr.) : E-mail (e-mail) :

3. Oplemenjivac/i sorte (The original hreeder(s) ofthe variety) D Oplemenjivac sorte je podnositelj zahtjeva (breeder of variety is applicant) □ Oplemenjivac sorte nije podnositelj zahtjeva (breeder of variety is NOT applicant) Oplemenjivac I Breeder I Oplemenjivac 2 Breeder 2 lme (First name): Ime (First name): Prezime (Last name): Prczim e (Last name): Poslovni subjekt : (Organisation) : Poslovni subj ekt: (Organisation) : Adresa: (Address): Adresa: (Address): Postanski broj (ZIP code): Mjesto (Place): Postanski broj (ZIP code): Mjesto (Place): Drfava (Country): Drzava (Country): OIB poslovnog subjekat (VAT number): O1B poslovnog subjekta (VAT number): Telefon (Phone Nr.) • Telefon (Phone Nr.): Telefaks (Fax Nr.) : Telefaks (Fax Nr.): IE-mail (e-mail): E-mai l (e-mail):

4. Odrzivac sorte Mai11tai11er Ime (First name): Prezime (Last name): Poslovni subjekt: (Organisation) : Adresa: (Address): Postanski broj (ZIP code): Mjesto (Place): Drzava (Country): 01B poslovnog subj ekta (VAT number): Telefon (Phone Nr.): Telefaks (Fax Nr.).· E-mail (e-mail):

5. Punomocnik odriivaca sorte (Uz zahtjev prilozite punomoc o zastupanju u postupku odrzavanja sorti poljoprivrednog bilja) Procedural represe11tative of the applicant a11d the mailltainer of the variety (As my procedural representative in respect of mainlenance of varietv) l me (First name): Prezime (Last name): Poslovni subjekt: (Organisation): Adresa: (Address) : Postanski broj (ZIP code): Mjesto (Place): Drzava (Country): OIB poslovnog subjekta (VAT number): Tclcfon (Phone Nr.): Telefaks (Fax Nr.): E-mail (e-mail):

6. Vrsta kojoj sorta pripada Species to which the variety belo11gs Latinsko ime vrste (Latin name):_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Hrvatsko ime vrste (Croatian name): _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ 7. lme sorte / denominacija (upotrebljavajte velika i mala slova) Variety de11omi11ation (using capital and little letters) Oplemenjivacka oznaka (Breeders reference). Ime sorte (Name ofthe variety):_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

8. Podaci o upisu sorte na sortnu listu i oplemenjivacko pravo sorte Information regarding national listing and plant breeder's rights of the variety D Sorta je prijavljena iii je upisana na sortnu listu u drugoj drzavi (The variety has been applied or has been listed to the National Variety list in any other country) Drzava (Country) lme ili predlozeno ime sorte U postupku upisa (Application Upisana (Varietv denomination) oendinv) (Alreadv listed) □ □ □ □ □ □ D Sorta nije upisana i nije prijavljena za upisivanje na sortnu listu u niti jednoj drugoj drzavi (The variety has NOT been listed and not applied/or National variety list in any other country)

9. Podaci o zastiti sorte (The variety protectio11 data) □ Soria je zasticcna u drugoj/irn drzavi/arna, naveditc u kojoj/im i godinu zastite (The variety has been protected in other countries, in which countries and year ofprotection): □ Sorta nije zasticena niti u jednoj drzavi (The variety has NOT been protected in other country)

10. Mjesto (adresa) odrzavanja sorte: (Locality (adress), where the variety maintenance takes place:) U Republici Hrvatskoj U drugoj zemlji clanici iii trecoj zemlji, kojoj je Europska komisija (in the Republic of Croatia) priznala istovjetnost za odrzavanje sorte (in other Member States or third countries, afforded the same guarantees as those carried out by the MS)

11. Prilozi (Enclosures) □ tehnicki upitnik (Technical Questionnaire) □ punomoc za zastupanje (Authorization ofthe Representative) □ izvjesce o DUS testiranju (DUS Test Report) □ dozvola za pustanje GMO-a u okolinu (Permission for releasing GMO in to environment) D ostalo, navedite priloge (other, specify): _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ 12. lzjava (Statemel1l) Prijavljujem se za postupak obnavljanja upisa sorte u pripadajuci Upisniku sorti poljoprivrednog bilja Republike Hrvatske (I apply for addition to the National Variety List in the Republic of Croatia.) Izjavljujem da su svi podaci u prijavi i prilozima potpuni i tocni (I declare that all data stated in the application and attachments, to the best ofmy f..71owledge, complete and correct). Suglasan/a sam da se Zavod moze savjetovati i razmj enjivati podatke sa drugim sortnim uredima (1 agree that , the Administration may consult and exchange data with other variety offices) Izjavljujem da cu platiti sve troskove i pristojbe u postupku obnavljanja upisa sorti poljoprivrednog bilja u predvidenim rokovima. (1 agree to pay all the costs and fees variety addition to the National Variety List). Mjesto: _ _ _ _ _ _ __ Datum:- - - - - - - (Place): (Date): Potpis i pecat podnositelja zahtjeva:_ _ _ _ _ _ _ _ _ _ _ _ _ _ __ (Signature and stump ofthe person entitled): M .P. Obrazac 5. (Form 5) PUNOMOC O ZASTUPANJlJ U POSTUPKU Mjesto za naljepnicu klase i ur. broja PRIZNA VANJA BIL JNIH SORTI Authorization of the Procedural Representative in the List of Varieties of the Republic of Croatia

1. Podnositelj zabtjeva Aoolicant [me (First name): Prezime (Last name): Poslovni subjekt: (Organisation): Adresa: (Address) : Po!;tanski broj (ZIP code): Mjesto (Place): Drzava (Counffy): OIB poslovnog subjekta (VAT number): Telcfon (Phone Nr.): Telefaks (Fax Nr.): E-mail (e-mail): 2. 0 p u n o m o c u j e m I hereby authorize lme (First name): Prezime (Last name): Poslovni subjekt: (Organisation): Adresa: (Address): Postanski broj (ZIP code): Mjesto (Place): Drzava (Country): OIB poslovnog subjekta (VAT number): Telefon (Phone Nr.): Telefaks (Fax Nr.): E-mail (e-mail): za zastupanje u postupku priznavanja sorti poljoprivrednog bilja u Republici Hrvatskoj. As my procedural representative in respect ofentering of variety to the National Variety List in the Republic of Croatia D za slijedece prijavljene sorte (the authorization refers to): Oplemenjivacka oznaka lme sorte Latinsko ime vrste Hrvatsko ime vrste (Breeders reference) (Variety name) (Latin name ofthe specieJ) (Croatian name of the species) Mjesto: _ _ _ _ __ Datum:- - - - - - Potpis i pecat podnositelja zahtjeva:_ _ _ _ _ _ _ _ _ __ (Place): (Date): (Signature and stump ofthe person entitled): M.P. Mjesto: _ _ _ _ __ Datum:- - - - - - Potpis i pecat punomocnika (zastupnika):_ _ _ _ _ _ _ _ __ (Place): (Date): (Signature and stump ofthe representative): M.P. Obrazac 6. (Form 6) PUNOMOC O ZASTUPANJU ODRZIVACA Mjesto za naljepnicu klase i ur. broja BILJNIH SORT! Authorization of the Procedural Representative of the maintainer of plant variety

1. Odrlivac sorte Maintainer lme (First name): Prezime (Last name): Poslovni subjekt: (Organisation): Adresa: (Address): Postanski broj (ZJP code).- Mjesto (Place): Drzava (Country) : OIB poslovnog subjekta (VAT number): Telefon (Phone Nr.): Telefaks (Fax Nr.) : E-mail (e-mail): 2. 0 p u n o m o c u j e m I hereby authoriz e lme (First name): Prczime (Last name): Poslovni subjekt: (Organisation): Adresa: (Address): Postanski broj (ZIP code).- Mjesto (Place).· Drzava (Country): OIB poslovnog subjekta (VAT number): Telefon (Phone Nr.): Telefaks (Fax Ni): E-mail (e-mail): za zastupanje u postupku odrfavanj a sorti poljoprivrcdnog bilja u Republici Hrvatskoj . As my procedural representative in respect ofmaintenance of variety in the Republic ofCroatia D za slijedece prijavljene sorte (the authorization refers to): Oplemenjivacka oznaka Ime sorte Latinsko ime vrste Hrvatsko ime vrste (Breeders reference) (Variety name) (Latin name ofthe species) (Croatian name ofthe species) Mjesto:_ _ _ _ __ Datum:_ _ _ _ __ Potpis i pecat odrzivaca:_ _ _ _ _ _ _ _ _ __ (Place): (Date): (Signature and stump ofthe maintainer): M.P. Mj esto:_ _ _ _ _ _ Datum:_ _ _ _ __ Potpis i pecat punomocnika (zastupnika): _ _ _ _ _ _ _ _ __ (Place).- (Date): (Signature and stump of the representative): M.P. Obrazac 7. (Form 7) PRIJEDLOG O IMENU SORTE / DENOMINACIJA Proposed variety denomination Mjesto za naljepnicu klase i ur. broja I. Podnositelj zahtjeva Applicant Ime (First name): Prezime (Last name): Poslovni subjekt: (Organisation}: Adresa: (Address): Postanski broj (ZIP code): Mjcsto (Place): Drzava (Country): Telefon (Phone Nr.): Telefaks (Fax Nr.): E-mail (e-mail).

2. Podaci o sorti na zahtjevu za priznavanje sorti poljoprivrednog bilja /11formatio11 regarding to variety applicatio11 to the N ational Variety List Vrsta kojoj sorta pripada (Species to which the variety belongs) Latinsko ime vrste (Latin name): _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Hrvatsko ime vrste (Croatian name): _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Oplemenjivacka oznaka (Breeder's reference):_ _ _ _ _ _ _ _ _ _ _ _ __ Upisni broj (Application number):_ _ _ _ _ _ _ _ _ _ _ _ __ 3. lme sorte / denominacija (upotrebljavajte velika i mala slova) Variety de11ominatio11 (using capital and liule leuers) Predlozeno ime (Proposed name) :_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

4. Predlozeno ime sorte / denominacija je Proposed designation is □ Zamisljeno ime (Fancy name) □ Kod (Code) Mjesto: _ _ _ _ _ _ _ _Datum: _ _ _ _ _ __ Place Date Potpis i pecat podnositelja zahtjeva:_ _ _ _ _ _ _ _ _ __ (Signature and stump ofapplicant): M.P.