………………………………………………………………………………………….. in the same of (2) ……………………………………………………………………… ……………………………………………………………………………………………. of (3) ……………………………………………………………………………………. …………………………………………………………………………………………… trading as (4) ……………………………………………………………………………. who is/are the proprietor(s) of the same trade mark registered in Class (5) …………………………………………………….., in respect of ……………………………………. under No. ………………………………………… The particulars of the facts on which I/we rely in support of this application are set forth in the accompanying statement of case (6). Dated this ……………………….. day of ………………………………….. 200……… (7) …………………………………………….. should be stated (3) Here insert the full trade or business address of the applicant (4) Here insert the trading style (if any). (5) Here insert particulars of the applicant’s registration of the trade mark. (6) To be furnished in duplicate. (7) Signature. The Registrar The Trade Marks Office, P.O. Box 100 BLANTYRE LAWS OF MALAWI Trade marks Trade Marks Regulations Cap. 49:01 (Subsidiary) MALAWI Form TM. No. 34 Sections 42. Regulations 40. TRADE MARKS ACT (CAP. 49:01) Regulations for governing the use of Certification Trade Mark No. ……………………………. in Class. ………………………. In respect of (1) ………………………………………………………………………………………….. (For Official Use) Advertised in Gazette No. …………………………………………………………. at page ……………………………………. on the ……………………………. day of ………………………………………………. Date of application and registration ……………………………………… 19…………) The Registrar The Trade Marks Office, P.O. Box 100 BLANTYRE (1) Here specify the goods of the registration.

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