Application for Arbitration

(Date)

To: JapanIntellectualPropertyArbitrationCenter

  1. Applicant

Domicile (Residence):

Telephone Number:

Fax Number:

E-mail Address:

Name (Title):

(Representative) Seal (Note 1)

  1. Agent forApplicant (Note 2)

Domicile (Residence):

Telephone Number:

Fax Number:

E-mail Address:

Name Seal

  1. Respondent

Domicile (Residence):

Telephone Number:

Fax Number: (Note 3)

E-mail Address:

Name (Title):

(Representative)(Note 4)

  1. Gist of the Application (Note 5)
  1. Grounds for the Application (Note 6)
  1. Existence of the Arbitral Agreement (Note 7)
  1. List of Attached Documents and Objects (Note 8)

(1)Written Application for Arbitrationfour copies of duplicates

(2)Documentary Evidenceone copy,

four copies of duplicates (Note 9)

(3)Arbitral Agreementone copy (Note 10)

(4)Certificate of Qualification

one copy eachfrom applicant and respondent (two copies in total) (Note 11)

(5)Power of Attorneyone copy (Note 12)

(Note 1)Where the applicant is a juridical person, the name of the person acting as its representative shall be provided here. Where there is an agent, the seal of the applicant is not required.

(Note 2)This information is required only in the case where there is an agent. Contact information shall be provided.

(Note 3)The respondent’stelephone number, fax number, and e-mail address shall be described insofar as the applicant has such knowledge.

(Note 4)Where the respondent is a juridical person, the name of the person acting as its representative shall be provided here.

(Note 5)In the “Gist of the Application,”please provide the main text of the arbitral award which the applicant seeks as an outcome of the arbitration.

(Example of Description)

(1) “The applicant hereby demands that as part of the arbitral award:

1. The respondent shallpay to the applicant yen and interest equivalent to X% per annum from (Date) to the full payment.

2. Thearbitral costs shall be borne by the respondent.”

(2) “The applicant hereby demands that as part of the arbitral award:

1. The respondent shallnot manufacture or sell XXX described in the list of products attached hereto.

2. The respondent shall dispose ofXXX and the half-finished products thereof, in possession of the respondent, and described in the list of products attached hereto.

3. Thearbitral costs shall be borne by the respondent.”

(Note 6)In the “Grounds for the Application,”please provide the facts and the applicant’s allegations which provide grounds for the claims described in the gist of the application section.

(Note 7)Since the fact that the parties have a valid arbitral agreement in advance is a prerequisite for the commencement of arbitral proceedings, such fact shall be described.

Example of Description: There is an arbitral agreement between the applicant and respondent indicated in the written arbitral agreement attached hereto.

(Note 8)This section may be divided into the means of evidence and attached documents,and both of them may be described after the model of a complaint, an answer, and preparatory briefs in the litigation.

(Note 9)Documentary Evidenceone copy, four copies of duplicates

The above shall be specified by the number and title as follows.

Exhibit A-1

Exhibit A-2

The number of copies of duplicatesshall be sum of the numbers of the respondents and arbitrators, and it shall be four when the number of the respondents is one and that of the arbitrators is three.

(Note 10)In case of necessity, a list of evidence (the title, date produced, author, and those matters which the material is intended to prove, etc. shall be described therein.) shall be submitted. The written arbitral agreement may be based on a previous contract, or may be agreed upon prior to the present application for arbitration;however,the arbitral agreement shall be completed in writing (Article 13, Paragraph (2) of Arbitration Law). An example of a typical arbitral agreement is shown below:

Article X Both parties agree that any dispute arising out of this agreement shall be resolved by arbitration under the Rules for Arbitral Proceedings in the JapanIntellectualPropertyArbitrationCenter. The location of arbitration shall be Tokyo, the arbitral award shall be final, and both parties shall accept the arbitral award. (As for the location of arbitration, the agreed upon location, such as Osaka, Nagoya, etc. shall be described in the arbitral agreement.)

(Note 11)In the case where the applicant is a juridical person, the certificate of qualification of the person acting as its representative and a certified copy of commercial registration, etc. shall be submitted. In the case where the respondent is a juridical person, those of the respondent shall be submitted by the applicant. When the number of the applicants is one and that of the respondents is two, and when all are juridical persons, a copy for each (three copies in total) thereof shall be submitted.

(Note 12)For example, when there are two agents: in the case where twoagents are described in one power of attorney, one copy thereof shall be submitted, and in the case where there are separate powers of attorney for each agent, a copy for each agent (two copies in total) thereof shall be submitted.