THE KENYA COPYRIGHT BOARD REQUEST FOR A CERTIFIED COPY Name and address of person making request Physical address of the person making the request Name and address of the agent (if any) Description of the document requested Reasons for the request Dated at …………………… this ……….. day of ………….. 20 ……… Signature(s) …………………………………. Applicant(s) NOTES: 1. Please use a separate form for each document requested. 2. This form may be used to obtain certified copies of documents or extracts. 3. Please describe any special requirements. If the space provided is not sufficient, please use a separate sheet of paper. FORM NO. CR 22 (r. 21) THE COPYRIGHT ACT, 2001 THE KENYA COPYRIGHT BOARD REQUEST FOR UNCERTIFIED COPY Name and address of person making request Physical address of applicant Name and address of the agent (if any) Description of the document a copy of which is requested Reasons for the request