IPINIIINGAff12 Page 63 16 TRADE MARKS ACT (FEE STAMP-ITEM 9 or 9a) Joint request to the Registrar by Registered Proprietor and Transferee to register the Transferee as subsequent Proprietor of Trade Marks upon the same devolution of title (Regulation 73) FORM We (a) '" . ................................................................................... . and (b) . hereby request, under regulation 73, that the name of (c) . .. .. .. .. .. .. .. . .. .. .. .. carrying on business as (d) .. ........................................ at (e) . may be entered in the Register of Trade Marks as proprietor of the trade Mark(s) No * in Class . as from the (f) by virtue of (g) .. (h) The trade mark at the time of assignment was (h) (not) used in a business in the goods in question, and the assignment (took) (Iz) (did not take) place on or after the commencement of the Act otherwise than in connection with the goodwill of a business in the goods, (h) and there is sent herewith a copy of the Registrar's direction to advertise the assignment, a copy of each of the advertisements complying therewith, and a statement of the dates of issue of any publications containing them. DATED this day of (i) 19 ()) . . . To: The Registrar of Trade Marks, Federal Ministry of Trade and Tourism, Abuja, Nigeria. (a) Name and address of Registered Proprietor, or other Assignor or Transmitter. (b) Full name, trade address and nationality of transferee. (c) Name of Transferee. (d) Description of Transferee (e) Trade or Business address of Transferee. (f) Date of acquisition of proprietorship. (g) Full particulars of the instrument of assignment or transmission, if any, or statement of case. (h) Strike out any words not applicable (see regulation 78). (i) Signature of Assignor or Transmitter. (j) Signature of Transferee. *Additional numbers may be given in a signed Schedule on the back of the Form.