IP/N/l/NGA/T/2 Page 97 FORM 50 TRADE MARKS ACT (FEE STAMP-ITEM 6/ or 6g) Application/or cancellation 0/ entry 0/ a Registered User 0/ a Trade Murk, iSection 34(5)(c)-Regulation 100). (To he accompanied hy a Statement of the Grounds /01' the application) IN THE MATTER OF Trade Mark(s) No.(s) registered in Class in the name of (a) . .. ........................................................................................ . Application is hereby made by (b) . (whose address for service in Nigeria in these proceedings is . ............................................................. for the cancellation of the entry under the above-mentioned registration(s) of (c) .. .... .. .. .. . . .. . .. . .. . .. . as a registered user thereof in respect of (d) . The grounds of this application, particulars of which are given in detail in the accompanying statement of case, are (e). DATED this day of To: The Registrar of Trade Marks, Federal Ministry of Trade and Tourism, Abuja, Nigeria. 19 .. *Additional numbers may be given in a signed Schedule on the back of the Form. (a) Here insert the name, trade or business address and description of the registered proprietor as entered in the Register. (b) Here insert the name and address of the applicant for cancellation. (c) Here insert the name, trade or business address and description of the registered user as entered in the Register. (d) Here insert goods in respect of which the registered user is entered. (e) Here insert one or more of the sub-paragraphs of section 34(5)(c) numbered (i), (ii), (iii). (/) Signature.