IP/N/I fKENff/1
Page 121
(Subsidiary]
FEE
Form TM 41
l .
J
ApPLlc:\TrO'J TO THE REGISTR:\R UNDER SECTION
FOR
DIRECTIO:--':S
OF
TR.\OE
FOR THE
!\1 ARKS
IN
_
AND RULE
80
25 (7)
ADVERTISEMENT OF
OTHER\\iISI3 THAN
1st Sch.,
item 8b
AN
ASSIGNMENT
CONNEXION
WITH
THE
GOODWILL Or THE BUSINESS
(To he accom ponicd by a duplicate)
Application is hereby made by (a) ..........•...............
.............................................................. ,
'0
.
of
.
for the Registrar's Directions with respect to the advertisement of an
assignment to him [them] of the following Trade Marks otherwise than'
inconncxion with the goodwill of the business in which they were used
at the time of assignment, namely-··
(1) Registered .Trade Marks:
Class
.Registration Number
Goods in respect of which the
Mark has been used and is
assigned
(h)
all of which are ,?r were registered
••
0
•
0
o
0
0
•••
•
••••
0
0
•••••••••••
0
•
0
•••
••••••••••••••
;
•
0
0
•••
the name of (c)
.
of
••
,
10
.
who is the assignor.
Unregistered Trade Marks (d), all being Marks used in his
business at the time of the assignment in respect of the goods stated
(c)
..
0
0
••••
0
•••••••••••••••••••••••••••••••••••••••••
~
of
who is the assignor:
Representation of Mark
(b) Additional
Marks and num
hers
may
be
given in a signed
schedule on the
back
of
tho
form.
(2)
below by
(a) Here insert
the name and
trade or business
address of the
assignee
(appli
cafit),
,
(c) Here insert
the name and
trade or business
address of the
proprietor
(3S
signor).
(d) Only those
unregis
tered trade marks
Goods in respect 'of which the Mark
has been used and is assigned
(b)
The date of assignment was the .
0
••••
0
••••••••••••••
0
day of
...................... , 19..•.
The instrument effecting the assignment is sent herewith, together
with a copy thereof.
passing by tbe
one assignment
and used in the
same
business
and for the same
goods as those
for which one
or more of the
registered marks
are registered
may be stated
here.
It is suggested that advertisement shall be directed as follows,
namely, in
Dated this
o' • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •
'day of
, 19
.
(e) ...•..........................•••.••..•.
(e) Signature.
To: The Registrar of Trade Marks,
PoO Box 30031,
Nairobi.
75 of 86