Rev. 2009] Trade Marks CAP. 506 121 [Subsidiary] FORM TM 39 Fee 1st Sch., item 8 Application For The Certificate Of The Registrar Under Section 25 (5) And Rule 79 With Reference To A Proposed Assignment Of A Registered Trade Mark (To be accompanied by a Statement of Case in duplicate and a copy of the proposed assignment) IN THE MATTER OF Trade Marks[s] No. [s] ……………………..... .......................registered in the name of ……………………………………… …………………………………....................................................................... in Class[es] …………………………………………..………………………. ……….……………………………………………………………………….. Application is hereby made by (a) ……………………………..…….. of …………………………………………………………………………...... (a) Here insert the name and trade or business address of the registered proprietor. being the Registered Proprietor[s] of the above-numbered registered Trade Mark[s], for the Registrar’s Certificate under section 25(5) with (b) Here insert the reference to a proposed assignment of the registered Trade Mark[s] No.[s] name and trade or …………………………….. to (b) ……………............................................... business address of the proposed ……………………………………………………………….………….......... assignee. of …………………………………………………………............................... in circumstances that are stated fully in the accompanying Statement of Case. Dated this ………………………… day of ……………, 20………… (c) ………………………………. To: The Registrar of Trade Marks, P. O. Box 30031, Nairobi. (c) Signature.