The Laws of Zambia (6) ................................................................................................................................................................................................ on the following official date (7) .................................................................................................................................................. numbered (8) ............................................................................................................Such application was the first application made in a convention country in respect of the relevant design, whether by the applicant(s) or by any person of whom he/they claim(s) to be the legal representative(s) or assignee(s), and the applicant(s) in the above-mentioned country qualify/qualifies under (9) Article 2/3 of the Convention by reason of being (9) a national(s) of/domiciled in/having a place of business in a member state, namely .......................................................................................................................................... (6) Her the nam the con country which t applica was ma (7) Her the offi of the f applica conven country (8) Her official of first applica conven country This application is made on the ground that I/we qualify under the said (9) Article 2/3 by reason of being (9) a (9) Dele national(s) of/domiciled in/having a place of business in a member whiche state, namely .............................................................................................................................................................................. does n and that to the best of my/our knowledge and belief there is no lawful ground of objection to the registration of the design and that I/we request that the design may be registered as of the date (7) .............................................................................................................................................................................. Dated this ..............................................................................................day of .........................................., 19 ............... (10) ............................................................................................ (10) To .................................................................................................... signed My/Our address for service in Zambia: applica .......................................................................................................................................................................................... his/thei .......................................................................................................................................................................................... .......................................................................................................................................................................................... The Registrar, The Designs Office, Lusaka, Zambia. NOTE.-Four identical representations or specimens of the design should accompany this form, and, except in the case of an application in respect of a design to be applied to a textile article, to wallpaper or to lace, it should further be accompanied by a statement of the features of the design for which novelty is claimed. Copyright Ministry of Legal Affairs, Government of the Republic of Zambia