The Laws of Zambia REPUBLIC OF ZAMBIA Designs Form No. 1 Section 9 Regulation 3 THE REGISTERED DESIGNS ACT Fee: 1 (a) or (c) APPLICATION FOR REGISTRATION OF DESIGN (NON-CONVENTION) Application is hereby made for registration of the accompanying design in the name of (1) ................................................................................................................................................................................................ (1) Stat name a .................................................................................................................................................................................................... addres .................................................................................................................................................................................................... applica (2) Her the arti .................................................................................................................................................................................................... which t design who claim(s) to be the proprietor(s) thereof. applied The design is to be applied to (2) ...................................................................................................................................... shown .................................................................................................................................................................................................... represe of ................................................................................................................................................................................................ .................................................................................................................................................................................................... .................................................................................................................................................................................................... .................................................................................................................................................................................................... .................................................................................................................................................................................................... (3) The design has been previously registered for one or more other articles under No. ............................................................................................................................ (4) The design consists of the design previously registered under No. ............................................................................ with modifications or variations not sufficient to alter the character or substantially to affect the identity thereof. (3) and Delete both paragra inapplic Dated this ..............................................................................................day of .........................................., 19 ............... (5) .............................................................................................. .................................................................................................... My/Our address for service in Zambia: .................................................................................................................................................................................... .................................................................................................................................................................................... .................................................................................................................................................................................... The Registrar, The Designs Office, Lusaka, Zambia. NOTE.-Four identical representations or specimens of the design should accompany this form, and, except in the case of an application in respect of a design to be applied to a textile article, to wallpaper or to lace, it should further be accompanied by a statement of the features of the design for which novelty is claimed. Copyright Ministry of Legal Affairs, Government of the Republic of Zambia (5) To b signed applica his/thei

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