REPUBLIC OF ZAMBIA
Designs Form No. 5
Section 9
Regulation 14
THE REGISTERED DESIGNS ACT
Fee unit: 1
APPLICATION FOR STATEMENT OF GROUNDS OF DECISION UNDER
REGULATION 14
Application for Design No
Application is hereby made under regulation 14 of the Registered Designs Regulations
for a statement in writing of the grounds of the decision dated the
day of , 19 ................ after the hearing on the .............................. 

day of , 19 ............. and the materials used in arriving at such
decision.
Dated this

day of .........................................., 19 ............... 

(1)

My/Our address for service in Zambia:

The Registrar,
The Designs Office,
Lusaka,
Zambia.

(1) To be
signed by
the
applicant(s)
or his/their
agent

Select target paragraph3