99
TRADE MARKS REGULATIONS, 1970 (L.I. 667)
of....................................................................................................................................
.....................................................
(who was his prcedecessor in title) in respect of the following goods,
namely..................................................................
.......................................................................................................................................
.....................................................
by
or
from
(e)..................................................................................................................................
...................................
......................................................................................................................................
....................................................
of....................................................................................................................................
................................................
who was the registered proprietor of the said trade mark, in circumstances that are
stated fully in the accompanying Statement of Case, for the approval by the
Registrar of the aforesaid (c) assignment (transmission).
Dated this ........................... Day of ......................... 19..............................................
(Signature) ..................................................
To The Registrar of Trade Marks,
Registrar-General's Department,
P.O. Box 118,
Accra.
_____________
(a) Insert here the name and trade or business address of the transferee who claims.
(b) Insert here the date, which must precede the appointed day.
(c) Strike out the words that are not applicable.
(d) Insert here the name and trade or business address of the predecessor in title, if
any.
(e) Insert here the name and trade or business address of the registered proprietor
who assigned or transmitted.