The date of assignment was the …………day of��…………………20….. Additional marks and numbers may be given in a signed schedule on the back of the form. Dated the …………………………………day of…………………..20……. (d) ……………………………………………………………………………. To: The Registrar of Trade Marks, P.O Box 6848, Kampala. 2079 (d)Signature