Rev. 2009] CAP. 506 Trade Marks 107 [Subsidiary] FORM TM 10 L.N. 146/2003. Renewal Of Registration Of Trade Mark (rules 64 (1), 65, 67, 68) Name and address of person leaving the registration fee: ………………………………………………………………………………… ………………………………………………………………………………… ………………………………………………………………………................ I, the person described above, leave the prescribed registration fee for the renewal of the following trade mark: Trade Mark No. …………………………………………………………….... Registered proprietor: ………………………………………………………... ………………………………………………………………………... I am (check one) the registered proprietor of the trade mark not the registered proprietor of the trade mark but have been directed by the registered proprietor to pay the fee The notice of renewal should be sent to the following address:* ………………………………………………………………………………… ………………………………………………………………………………… ………………………… Date: ………………………………. Signature: ……………………………. To: The Registrar of Trade Marks. *The person completing the form to provide name of addressee.