PARTD
APPLICATION FOR REGISTRATION OF A LICENCE OF RESERVED
WORK,S OF FOLKLORE
CNRFORM4
FOR OFFICIAL USE
Section(s)-85 of Act
Section(s) 13 of Regulations
Received on: .............., ..................
APPLICATION FOR REGISTRATION OF .
A LICENCE
IN TERMS OF SECTIOJ'J 85 OF THE ACT
TO: Registrar of Copyright and Neighbouring Rights
HARARE
Licensee'slAgen! ref: ........
I. In the matter <if application for registration'of a licence in terins of section 85 of
the Act
Registration No: .......................,............ .
Filing date: ..................... :.............. ..
"ride of work: ......................... :.: ............
Registration date: ...........:................ .
Category ofworic.: ......... :............................................................................:............ .
2.
.
OwnerslI...iceasee name: ....................................... :.; ........................ :............ :........... .
Address: .. ,..................................... _...............: ........,: ............. :............................... ..
,'..................................................................................... :, ............................ .
3.
Licensee's name: ................. :........ :......... ..
Nationality: ................................... ..
Address: ...................................................:..........................." ........ .............................. _.
DomiciJelPrincipai place of b~siness: ....... :..... :........................................................ .
4.
APPLICATION
"
(8)
'I1!e licensee(s), hereby applies(y} for the registration of the licence in respect of the
above-identified reserved mark(s) of the folklore subject 10 the folJowil)g contition(s).
(b)
UWe are entitled 10 the reserved work of folldbre by virtue of:
o
D
the accompanying licence.
Any other document specify.
5. . THUSOONEANDSIGNEDAT.....": .......... this .... :..........dayof ............. 20...:........... .
Address for service: ............ :....................... ..
Applicant(s)/Agent for applicant(s)