A registered proprietor or registered user whose address has been altered by a public authority, so that the changed address designates the same premises as before, may make also the statement below in ord To: (For use only in case of an address changed by a public authority, without change of premises.) The change of address, for the entry of which application is made above, was ordered by ........................................................................................................................... on the ........ Note: If the above statement be made, and a certificate of the alteration given by the named authority be supplied the Registrar, if satisfied as to the facts of the case, will not require Form TM/SM 15 to be fee paid (see Reg. 65.) FORM TM/SM 16 APPLICATION TO THE REGISTRAR TO DISSOLVE THE ASSOCIATION BETWEEN A REGISTERED MARK AND (AN) OTHER MARK(S) TANZANIA THE TRADE AND SERVICE MARKS ACT (CAP. 326) (Section 41(5) and Regulation 48 and 69) FEE SHS. 50,000/= (To be accompanied by a Statement of Case) IN THE MATTER OF a Mark No. .................................................... Registered in Class ............................................................... I (or We) ................................................................................................................. the Registered Proprietor(s) of the above numbered Mark, hereby apply that the association of this Mark with the following Mark(s) registered in my (our) name: No. ..................... registered in Class ....................................... No. ...................... registered in Class ...................................... may be dissolved and the Register amended accordingly. The grounds for this application are set forth in the accompanying Statement of Case. Dated this ........................ day of ........................ 20........ lxxvi To: 1 The Dar Tanza FORM TM/SM 17 REQUEST FOR CORRECTION OF CLERICAL ERROR OR PREMISSION TO AMEND APPLICATION TANZANIA THE TRADE AND SERVICE MARKS ACT (CAP. 326) (Section 39(1) and Regulation 69) FEE