7. Full name and address of the applicant Applicant’s reference (Optional) Signature Date FORM M2 (regulation 33) REPUBLIC OF THE GAMBIA THE INDUSTRIAL PROPERTY ACT Cap. 95:03 THE INDUSTRIAL PROPERTY REGULATIONS 2010 No Fee Withdrawal of Application for Registration of a Mark To: The Registrar General, Attorney General’s Chambers Ministry of Justice Marina Parade, Banjul, The Gambia. 1. Application Number GM/M/ 2. Short Description of Mark 3. Class or Classes 53