PARTC
APPLICATION FOR REGISTRATION OF A LICENCE
CNRFORM3
.Section(s)-49 of Act
Section(s) 11 of Re8ulatioos
FOR OFFICIAL USE
Received on: ..................•..............
APPLICATION FOR REGiSTRATION OF
AUCEN~E .
IN TERMS OF SECTION 49 OF TIm ACT
RegistIlr of Copyript and Neijhbouring
Rights
HARARE
Licensee'siAgent ref: ....... .
TO:
1. In the matter of application for registration of a licence in terms of section 49 of
tbeAct
Registration No: .................................... .
F'I!ing date: ..................................~ ...
TItle of work: ................, ....................... .
RegiStration date: .............................
Category of work: ....................~ .............................,............. _ .................................
2. OwoerslLicensee Name: ..................................
¥ .........._ ........................................ ..
Address: .................................................................................................................. .
.................................................................................! ......... h~ . . . . . . . . . . . . . . . . . . . . . . . .
·.u
l'
3. Licensee's Name: ......................................
Nationality: ....................,................
Address: ................:.................:........................;......................................................:
DomicileJPrincipal place ofbusiness: ..................................................................... ..
4.
APPUCATION .
<a>
The above-identified ownenllicensor bereby join, in applicaliol'l with the lic:cnsce 110
that the liCence may be reail~ in _pect of the obove-identiticd copyrigbt subject to
the folJowiDl conditions or reslrictions.
5.
(b)
1be~tamO(lK:aIcecodson ................. .dayof .........~..... .Jiswilboutlimitofperiod.
(c)
The 1k:euc:O wiJllwiU not be on exclusive licence.
nrus DONEANDSIGNSDAT.................this ...............dayof:............2O'............. ..
Address for service: ......................... :...........
• • • • • • • • • • • • • • • • • • • •.J . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
AppIk:ant(s)lAgent for applli;ant(s)