58 TRADE MARKS REGULATIONS, 1970 (L.I. 667) (d) Strike out any words not applicable (see Regulation 36). *N ¢ 1.00 for each additional mark. Form TM—No. 15 TRADE MARKS REGULATIONS, 1970 DECLARATION (ONLY TO BE FURNISHED WHEN REQUESTED BY REGISTRAR) IN SUPPORT OF STATEMENT OF CASE ACCOMPANYING FORM TM—No. 13 OR TM—No. 14 I, ..................................................................................... ............................................................................................ of Do hereby solemnly and sincerely declare that the particulars set out in the Statement of case, exhibit marked ......................................... and left by me in connection with my request to be registered as subsequent proprietor of the trade mark No. ........................................................ in Class .............................................. are true and comprise every material fact and document affecting the present proprietorship of the trade mark. (a) And I make this solemn declaration conscientiously believing the same to be true and by virtue of the provisions of the Statutory Declarations Act, 1935. (b) ........................................................................................................... Declared at ............................................... .......................... 19 ........................................... this ........................... day of Before me (c) ....................................................................................................................................... ............................... ......................................................................................................... To The Registrar of Trade Marks, Registrar-General's Department P.O. Box 118, Accra.