REPUBLIC OF ZAMBIA
Designs Form No. 16
Section 6 or 22
Regulation 19 (2)
THE REGISTERED DESIGNS ACT
Fee unit: 1
APPLICATION FOR ENTRY OF NOTIFICATION OF DOCUMENT IN REGISTER
I/We transmit herewith an attested copy of (1)
relative to design No as well as the original document for
verification, and I/we apply that a notification thereof may be entered in the register.
Dated this
day of .........................................., 19 ................
The Registrar,
The Designs Office,
Lusaka,
Zambia.
(1) Here
insert a
description
of the
nature of
the
document,
giving its
date and
the names
and
address of
the parties
thereto
(2)
(2)
Signature
(3)
(3) Here
insert full
address of
the party
benefiting
under the
document