IP/NI 1IKENfTl 1 Page 110 (Subsidiary] FEE Form T~1 30 1st Sch., items 23, 23a REQUEST FOR GENERAL CERTIFICATE OF THE REGISTRAR (INCLUDING CERTIFICATE OF REGISTRATION OF A TRADE MARK) (Rule 109) •...•• These words may .be varied to suit other cases. (a) Here set out the particulan which the Regis­ trar is required to certify. (b) Strike out words that are not applicable. IN THE MATTER OF *the Trade Mark No. registered i.n Class . pi I [We] . hereby request the Registrar to furnish me [us] with (b) his Certificate that (a) .. ' . ..... .. .. ......... .. ....... . ... .. ... ...... . ...... ...... ....... . (b) a Certificate. of Registration of the Trade Mark (b) for use in obtaining registration abroad. Dated this (c) Signature. (d) Address. day of 0 19 . (c) ...•...••...............•....•........•. (d) •. To: The Registrar of Trade Marks, P.O. Box 30031, Nairobi. Rule11l. (1) Where a certificate of registration ofa trade .nark is issued for use in obtaining registration abroad. the Registrar shall include in. the certificate a copy of the mark. an? may require the applicant for the certificate to furnish him with a copy of the mark suitable for the purpose, and if the applicant fails to do so may refuse to issue the certificate. (2) The Registrar may state: in the certificate such particulars concerning the registration of the mark as to him seem fit, and may omit therefrom reference to any disclaimers appearing in the register; but in the last-mentioned case the certificate shall be marked "For use in obtaining registration abroad only". 64 of 86