ICT Policy Africa

lv

Strike out any words not applicable (see rule 76).
Strike out any words not applicable (see rule 76).
lvii
Strike out any words not applicable. (see rule 76).
lvi

lviii

Signature of assignor or transmitter.
Signature of transferee.

lix
lx

Here insert full name, trade or business address, nationality and description.
Additional numbers may be given in a signed schedule on the back of the form.
lxii
Date of acquisition of proprietorship.
lxiii
Here insert full particulars of the instrument of assignment or transmission, if
any, or statement of case.
lxiv
Strike out any words not applicable.
lxv
Strike out any words not applicable.
lxvi
Strike out any words not applicable.
lxi

lxvii

Signature.
To be signed by the person making the declaration.

lxviii
lxix

Signature and title of authority before whom declaration is made.
Additional numbers may be given in a signed schedule on the back of the form
lxxi
Strike out one of these words
lxxii
Strike out one of these words
lxxiii
Signature
lxxiv
Here insert the name of the public authority ordering the change, and the date
thereof
lxxv
Signature of the registered proprietor or user, as the case may be
lxxvi
Signature.
lxxvii
Signature.
lxxviii
Here insert words and reference number identifying the entry or application.
lxx

lxxix

Signature.

lxxx

Here insert present name, address, and description of registered proprietor or
registered user.
lxxxi
my or our
lxxxii
Strike out the words not applicable.
lxxxiii
Additional numbers may be given on a signed schedule on the back of the
form.
lxxxiv

I am or we are.

lxxxv

Strike out the words not applicable.
Strike out the words not applicable.
lxxxvii
Here state the circumstances under which the change of name took place.
lxxxvi

lxxxviii

Signature.

lxxxix

Here insert the trade or business address and description of the applicant(s)
or his (their firm).
xc
Here insert the trade or business address and description of the applicant(s) or
his (their firm).
xci

Signature.

xcii

Here insert the trade or business address and description of the applicant(s) or
his (their firm).