REPUBLIC OF ZAMBIA
Designs Form No. 4
Sections 9 and 13
Regulations 3 and 11
THE REGISTERED DESIGNS ACT
Fee: 1 (b)
APPLICATION UNDER SECTION 13 OF THE ACT FOR REGISTRATION OF
DESIGN TO BE APPLIED TO A SET OF ARTICLES (CONVENTION)
Application is hereby made for the registration of the accompanying design in the name
of (1)
of
being a national/nationals of
who claim(s) to be the proprietor(s) thereof (2)
The design is to be applied to a (3)
(1) State
full name
and address
of
applicant(s)
(2) If the
applicant
is not the
person
who made
the
application
in the
convention
country,
the words
"by virtue
of",
followed
by
particulars
of the
instrument
under
which he
claims,
should be
inserted
here