TANZANIA THE TRADE AND SERVICE MARKS ACT (CAP. 326) (Section 46(a) and Regulation 78) FEE SHS. 30,000/= (To be accompanied by a Statement of the Grounds for the application and the Written consent (if given) of the Registered User.) Application is hereby made by cxliv 1 .............................................................................. .................................................................................................................................. .................................................................................................................................. the proprietor of Mark(s) No.(s) ................................................................ cxlv 2 registered in Class ................................................................. in respect of cxlvi 3 .................................. .................................................................................................................................. .................................................................................................................................. as a registered user of the above numbered Mark(s) in respect of cxlvii 4 ................................. .................................................................................................................................. .................................................................................................................................. .................................................................................................................................. may be varied in the following manner: cxlviii 5 ....................................................................... .................................................................................................................................. Dated this ........................ day of ........................ 20........ cxlix 6 ............................................................................ To: The Registrar of Trade/Service Marks, Dar es Salaam, Tanzania. FORM TM/SM 33 APPLICATION BY THE REGISTERED PROPRIETOR OF A MARK OR BY ANY OF THE REGISTERED USERS OF THE MARK FOR THE CANCELLATION OF ENTRY OF A REGISTERED USER THEREOF THE TRADE AND SERVICE MARKS ACT (CAP. 326) (Section 46(b) and Regulation 79) FEE SHS. 6,000/= (To be accompanied by a Statement of the Grounds for the application) Application is hereby made by cl 1 .............................................................................. .................................................................................................................................. .................................................................................................................................. being cli 2 the Registered Proprietor (a Registered User) of Mark(s) No.(s) ........................... ................................ clii 3 registered in Class .................................................................. in respect of cliii 4 ............................................................................................................. .................................................................................................................................. .................................................................................................................................. for the cancellation of the entry under the above mentioned registration(s) of cliv 5 ................................................................................................................................ .................................................................................................................................. as a registered user of the Mark(s) in respect of clv 6 .......................................................... The grounds for this application are set forth in the accompanying statement. Dated this ........................ day of ........................ 20........ clvi 7 ................................................................................................