Regulation 67 FORM TM-50 FEE: THE REPUBLIC OF UGANDA THE TRADE MARKS ACT,2010 Application by the Registered Proprietor of a trade Mark or by any of the Registered Users of the Trade Mark for the cancellation of entry of a Registered User thereof (Regulation 67) (To be accompanied by a Statement of the Grounds for the application) APPLICATION TO HEREBY MADE by (a)………………………………………….………………………………… ………………………………………………….….………………………… ……………………………………….. being (b) the Registered Proprietor (a Registered User) of Trade Mark(s) No………. ……………………………… Registered in Class …………………………………………...in respect of (c) ………………………………………………………………………………… …………………………………………………..…………………………… ……………………………………………………………………… for the cancellation of the entry under the above- mentioned registration (s) of (d)……………………………………………………………………………. ………………………………………………………………………………… as a Registered User of the trade mark (s) in respect of (e)……………………………………………………………………………… …………………………………………………………………………………. Dated this …………… day of …………………………………20………… (f) ……………………………………………………………………………. ………………………………………………………………………………… To: The Registrar of Trademarks, P.O.Box 6848, Kampala. (a)Here insert full name, description and trade or business address of the applicant(s). (b) Strike put the words that are not applicable. *Additional numbers may be given in a signed schedule on the back of the form. (c) Here insert the specification in the Register. (d) Here insert full name, description and trade of business address of the registered user whose entry is sought to be cancelled. (e) Here insert goods in respect of which that registered user is entered. (f) Signature. 2085