IPIN/lINGA/T/2 Page 88 FORM 41 TRADE MARKS ACT (FEE STAMP-ITEM Sa) Application for Extension of time in which to apply for the Registrar's Directions for the Advertisement of an Assignment of Trade Marks otherwise than in connection with the goodwill of the business (Section 26(4) and Regulation 81) Application is hereby made by (a) . of . for extension of time of (b) month(s) in which to apply for the Registrar's Directions for the advertisement of an assignment to him (them) of the following Trade Marks otherwise than in connection with the goodwill of the business in which they were used at the time of assignment, namely: (I) Registered Trade Marks: Registration Number Class Goods in respect of which the Mark has been used and * is assigned. all of which are to be registered in the name of (c) .. of who is the assignor; (2) Unregistered Trade Marks, all being Marks used in his business at the time of the assignment in respect of the goods stated below, by (c) .............................. of who is the assignor. Goods in respect of which Representation of Mark the Mark has been used and is assigned . DATED this ........... day of 19 .. (d) . To: The Registrar of Trade Marks, Federal Ministry of Trade and Tourism, Abuja, Nigeria. The date of assignment was the day of 19 . *Additional Marks and numbers may be given in a signed Schedule on the back of the Form. (a) Here insert name and trade or business address of the assignee (applicant). (b) Here insert: "one" or "two" or "three". (c) Here insert the name and trade or business address of the proprietor (assignor). (d) Signature.