LAWS OF MALAWI Trade marks Trade Marks Regulations Cap. 49:01 (Subsidiary) MALAWI Form TM. No. 53 Section 33(8)(c). Regulation 100. TRADE MARKS ACT (CAP. 49:01) Fee: 6(f) or 6(g). Application for cancellation of entry of a Registered User of a Trade Mark. (To be accompanied by a statement of the grounds for the application.) IN THE MATTER OF trade mark(s) No.(s) * ………………………………………… registered in Class ………………………… in the name of (1) ……………………….. …………………………………………………………………………………………… Application is hereby made by (2) ……………………………………………………… …………………………………………………………………………………………… ……………………………………………………………………………………….. ………………………………………………………………………………………….. for cancellation of the entry under the above-mentioned registration(s) of (3) ………… ………………………………………………………………………………………….. as the registered user thereof in respect of (4) …………………………………………. …………………………………………………………………………………………… ………………………………………………………………………………………….. The grounds of this application, particulars of which are given in detail in the accompanying statement of case, are (5) ……………………………………………….. ………………………………………………………………………………………….. …………………………………………………………………………………………. Dated this ……………………….. day of ………………………………….. 200……… *Additional numbers may be given in a signed schedule on the back of the form. (1) Here insert the name trade or business address and description of the registered proprietor as entered in the register. (2) Here insert the name and address of the applicant for cancellation. (3) Here insert the name, trade or business address and description of the registered user as entered in the register. (6)…………………………………………….. ……………………………………………… ……………………………………………… ……………………………………………… (4) Here insert the goods in respect of which the registered user is entered. My/Our address for service in Malawi is:………………………………………………… ………………………………………………… ………………………………………………… (5) Here insert one or more of the subparagraphs of section 33(8)© numbered (i), (ii), (iii). The Registrar The Trade Marks Office, P.O. Box 100 BLANTYRE (6) Signature.