Marina Parade, Banjul, The Gambia.
Request is hereby made by the applicant mentioned below for the registration of an
industrial design in accordance with the following details.
Application Number
(To be applied by the Registrar
GM/D/
General)
1. Full name and address of the
applicant. (underline surname);
Applicant’s reference
(Optional)
2. Short Description of the Design
3. Name of agent;
Address for service to which all
correspondence should be sent.
4. Priority Declaration: If priority
is claimed from one or more
earlier applications elsewhere
enter details opposite or use
separate sheet.
Priority
Country
Priority Date
(day/month/year)
Application
No.
(if known)
5. Creator (must be individual
not company) Is the applicant
the creator of the design? Enter
“yes” or “no” opposite. If the
answer is “no” this application
must be accompanied by a
statement justifying the
applicant’s right to be
registered.
Description
Drawing/s
6. Accompanying Material:
Photograph/s
Check and enter number of
Specimen (not
pages(where applicable) of
exceeding
each item opposite
20x20x20 cm.)
Other/s
(Specify)
The prescribed fee under the Second Schedule to the Regulations is remitted herewith.
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