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Form D18
Application for the restoration of a lapsed design registration
(Section 23 - Regulation 35)
(Lodge in duplicate)
Date of lodgement:
Design application/registration No

Full name(s) of registered proprietor:

Full address(es) of registered proprietor(s)

Class:
Type of design

1.
2.(a)
2.(b)
3.

Part A

Part F

I/we hereby apply for the restoration of the above-mentioned design registration.
I am/we are the proprietor's) mentioned above; or
I am/we are authorised to represent the above-mentioned proprietor(s) in this
application.
The circumstances under which the design registration lapsed and the grounds on
which restoration is requested are set out in the accompanying affidavit(s).

Date:
________________________________
APPLICANT/APPLICANT'S AGENT
Address for service:

FOR OFFICIAL USE ONLY
1.
2.
3.

Official date stamp

Lodgement of this document/accompanying document(s) acknowledged.
The above application is to be published in the journal.
The above application has been allowed/refused.

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