63 TRADE MARKS REGULATIONS, 1970 (L.I. 667) ....................................................................................................................................... ...................................................... ....................................................................................................................................... ...................................................... ....................................................................................................................................... ...................................................... ....................................................................................................................................... ...................................................... ....................................................................................................................................... ...................................................... ....................................................................................................................................... ...................................................... ....................................................................................................................................... ...................................................... ....................................................................................................................................... ...................................................... Dated this ................................................................. day of .............................. 19.................................................... (Signature) ................................................................... To The Registrar of Trade Marks, Registrar-General's Department, P.O. Box 118, Accra. ____________________ (a) Here insert words and reference number identifying the entry or application.