94
TRADE MARKS REGULATIONS, 1970 (L.I. 667)

of
.......................................................................................................................................
...............................................
.......................................................................................................................................
.....................................................
being the registered proprietor(s) of the above-numbered registered trade mark(s),
for the Registrar's certificate under section 22 (6) with reference to a proposed
assignment
of
the
registered
trade
mark(s)
No.(s).............................................................................................
to
(b)
.......................................................................................................................................
..........................................
of....................................................................................................................................
...................................................
.......................................................................................................................................
....................................................
in circumstances that are stated fully in the accompanying statement of case.
Dated
this
......................................
19........................................

day

of.......................................

(Signature).......................................................................
To The Registrar of Trade Marks,
Registrar-General's Department,
P.O. Box 118,
Accra.
________________
(a) Here insert the name and trade or business of the registered proprietor.
(b) Here insert the name and trade or business of the proposed assignee.
*N ¢ 1.00 for any additional mark proposed to be assigned.

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