....................................................................................................................................... ....................................................................................................................................... ....................................................................................................................................... ....................................................................................................................................... ....................................................................................................................................... ....................................................................................................................................... ....................................................................................................................................... ....................................................................................................................................... ....................................................................................................................................... ....................................................................................................................................... in the name of xv 4 ............................................................................................................. whose trade or business address is xvi 5 ............................................................................... ....................................................................................................................................... ....................................................................................................................................... trading as xvii 6 ..................................................................................................................... ....................................................................................................................................... by whom it is proposed to be used xviii 7 and who claim(s) to be the proprietor(s) thereof. xix 8 .................................................................................................................................... ....................................................................................................................................... ....................................................................................................................................... Dated this .............................. day of .............................. 20........ xx 9 .................................................................................................................................... ...................................................................................................................................... To: The Registrar of Trade/Service Marks, Dar es Salaam, Tanzania. FORM TM/SM 3 ADDITIONAL REPRESENTATION OF A MARK, TO ACCOMPANY APPLICATION FOR REGISTRATION TANZANIA THE TRADE AND SERVICE MARKS ACT (CAP. 326) (Section 21(2) and Regulation 20) xxi 1 xxii 2 Six of these Additional Representations of the Mark must accompany this Form of Application. To: The Registrar of Trade Marks, Dar es Salaam, Tanzania FORM TM/SM 4 REQUEST FOR STATEMENT OF GROUNDS OF DECISION TANZANIA THE TRADE AND SERVICE MARKS ACT (CAP. 326) (Section 26(5) and Regulation 30)