Rev. 2009]

CAP. 506

Trade Marks

113
[Subsidiary]

To: The Registrar of Trade Marks
FORM TM 22

L.N. 146/2003.

Application To Surrender Trade Mark For Some Goods And Services
(rule 84A (1) (b))
In the matter of Trade Mark No. ……………………………………………..
Class: ………………………………………….
Name of registered proprietor: ……………………………….........
Trade or business address: …………………………………............
Description of trade mark: …………………………………………
I, the proprietor of the trade mark described above, apply to surrender the trade
mark in respect of the following goods or services:
…………………………………………………………………………………
…………………………………………………………………………………
………………………..…………………………………………………….....
Names and addresses of persons with a registered interest in the trade mark:
…………………………………………………………………………………
……………………………………………………………………………........
………………………………………………………………………………....
Attached to this application is a certification by the proprietor that each person
with a registered interest listed above either –
(i) has been given notice of the proposed surrender at least ninety
days before the application is made; or
(ii) is not affected by the surrender or has consented to it.
Date: ………………………………………….
Signature: ………………………………………
To: The Registrar of Trade Marks.
FORM TM 23

L.N. 146/2003.

Application To Enter Disclaimer Or Memorandum
In Register
(rule 85 (2))

Select target paragraph3