65 TRADE MARKS REGULATIONS, 1970 (L.I. 667) ....................................................................................................................................... ..................................................... ....................................................................................................................................... ..................................................... The entry at present standing in the Register gives my (or any) name(s) and description(s) all as follows .................... ....................................................................................................................................... ..................................................... Dated this .......................................................... ............................ 19................................................. day of (Signature) ........................................................................ To The Registrar of Trade Marks, Registrar-General's Department, P. O. Box 118, Accra. ________________ (a) Here insert present name, address, and description of registered proprietor or registered user. (b) Strike out the words that are not applicable. * Additional numbers may be given on a signed schedule on the back of the form. (c) I am or We are. (d) Here state the circumstances under which the change of name took place. Form TM—No. 20 TRADE MARKS REGULATIONS, 1970