FORM D6 (regulation 28) REPUBLIC OF THE GAMBIA THE INDUSTRIAL PROPERTY ACT Cap. 95:03 THE INDUSTRIAL PROPERTY REGULATIONS 2010 CERTIFICATE Of the Registration of an Industrial Design 1. Design Number GM/D/ 2. Short Description of Design 3. Name and Address of Owner 4. Address for Service 5. Filing Date 6. Priority Date 7. Priority Country 8. Effective Date Signature …………………………….. Registrar General Date 49