336 REGISTRAR'S OFFICE, LESOTHO Form No. 10 (Reg. 56 (1) ) INDUSTRIAL PROPERTY ORDER RECORDING OF CHANGE IN OWNERSHIP For Official Use Received on: To: The Registrar P.O. Box 33 Maseru 100 I. IN THE MATTER OF: D D D D D D D D U. Patent Application No: Filing Date: Application for Utility Model Certificate No.: Filing Date: Application for Registration of Industrial Design No.: Filing Date: Application for Registration of Mark No.: Filing Date: Patent No.: Date of Grant: Utility Model Certificate No.: Date of Grant: Industrial Design No.: Date of Registration: Mark No.: Date of Registration: APPLICANT(S)/OWNER(S)* Name(s): , i • 1 Ii I Add ress( es): ) t, ; III. REQUEST The Registrar is hereby requested to record the change in ownership of the above- .' identified .................................................................................. **] The present applicant(s)/owner(s)* is/are identified above. ! The new applicant(s)/new owner(s)* is/are indentified below. IV. NEW APPLICANT(S)/NEW OWNER(S)* Name(s): Address(s): Address for service in Lesotho: ~ ( !