8th Fe bruary, 20G8
5
(reg. 12)
PART III
CO PYRI G HT A CT
(C AP_49 :0 3)
FOK.'vI C
APPLICATIO:-: TO Pt.:RCHASE HOLOCiRA\1 FROY! THE COPYRIGHT SOCIETY OF \1ALAWI
I. :\ame of Impol1er/Applieanl : _
2. Address: .. .... _.. _.. _.. __._ ...... . _..... _.
Te lepho ne
~ umb c r
3.
~ u lnbc r:
....... __ ... __ ......... ..... ...... .... ............. .. Fax : .............. ....... ........... .
of holograms required : ..... .... ...... ..... . _.... .... ___ .. .. . _._ .. _._ ... _...... _. _, .. . _.... ,...... ..... _...
4. Xa me of author(s) of work: ... _..._......._..._...._._ ....._._ . ____ __._. __ .______ ._. __.._._ .. ..._...... _........_.. ._..
5.-{ I) Has im porter obtained the autho ri zatio n of the producer or h is authorized
repre scntantive to impol1 the said work(s ): Yesl:\o.
(2) If yes picase anach evidence.
6 . Declaration:
I/\Ve declare on my/our honour th at the infonnation g iven above is true to the best of
my/o ur kn o wledge and that any misinfo nn ation previded by me/ us renders my/our
application null and void .
Declared at ._._. __ ____ .__ ___________ .____ __
..................... .. on
__ _____ .__ ..... ___ ._._ .. 20 ___ ._.
Sg nalUre of App/icon/
"OTE:
I. Genuine ho log ram of th e country o f orig in of tbe impor.ted works affix ed on to the
work s; or
2 . Authe ntic ation from the producer of the work to import the work(s) for which this
approval is being soug ht.
PART IV
(r-eg_ I;; )
COPYRIGHT ACT
(CAP. 49:03)
fORYt D
ApPROVAL TO PCRCHASE HOLOGRAMS FROM TIlE COPYRIGHT SOCIETY OF MALAWI
Approval is hereby given to: ______ ___ ..______ ._ .. __ ... ......... .. .... __ ... __ .... :_ of ...__ ........ __ _..._............
...... ..... ....... .... ..... .. ... .... ...... ... .......... to pur-cnase ............... ............. .... _....... ... .... holograms