REPUBLIC OF ZAMBIA

Designs Form No. 23 

Section 25 (2) 

Regulation 27 (2) 

THE REGISTERED DESIGNS ACT
Fee Unit: 1
APPLICATION FOR CANCELLATION OF REGISTRATION UNDER
SECTION 25 (2) OF THE ACT
Design No.
I/We
of
hereby apply for cancellation of the registration of design No.
on the ground that (1)

Dated this

day of ......................................., 19 ............ 

(2)

My/Our address for service in Zambia:

The Registrar,
The Designs Office,
Lusaka,
Zambia.
NOTE.-The application must be accompanied by a copy thereof and a statement of case in
duplicate.

(1) Here
state
ground(s)
on which
cancellation
is requested
(2) To be
signed by
the
applicant(s)
or his/their
agent

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