FEE SHS. 50,000/= I/We of xlvii 1 ......................................................................................................................... ..................................................................................................................................... and xlviii 2 ............................................................................................................................ ..................................................................................................................................... ..................................................................................................................................... hereby request, under regulation 57, that the name of xlix 3 .................................................... ..................................................................................................................................... Carrying on business as l 4 .............................................................................................. ..................................................................................................................................... at li 5 .............................................................................................................................. may be entered in the Register of Marks as proprietor of the Mark(s) No. ........................... in Class lii 6 ......................................... as from the liii 7 .................................................... by virtue of liv 8 ...................................................................................................................... ..................................................................................................................................... The Mark at the time of the assignment was/was not lv 9 used in a business in the goods or services in question, and the assignment took/did not take lvi 10 place on or after the appointed day other than in connection with the good will of a business in the goods, lvii 11 and there is sent herewith a copy of the Registrar's direction to advertise statement of the dates of issue of any publication containing them. Dated this ........................ day of ........................ 20........ lviii 12 ...... lix 13 ..... To: Note: The instrument under which the Transferee claims should preferably accompany this FORM TM/SM 13 REQUEST TO THE REGISTRAR TO REGISTER SUBSEQUENT PROPRIETOR OF A MARK UPON THE SAME DEVOLUTION OF TITLE TANZANIA THE TRADE AND SERVICE MARKS ACT (CAP. 326) (Section 40(3) and Regulation 58) FEE SHS. 50,000/= I (or We) lx 1 .................................................................................................................. ..................................................................................................................................... ..................................................................................................................................... hereby request that my (or our) name may be entered in the Register of Marks as proprietor .......................................................... of Mark(s) No. ................................................. lxi 2 in Class .................................................. as from the lxii 3 ................................................. I am (or We are) entitled to the Mark(s) by virtue of lxiii 4 .................................................... ..................................................................................................................................... The Mark at the time of the assignment was/was not lxiv 5 used in a business in the goods/services in question, and the assignment took/did not take lxv 6 place on or after the appointed day otherwise than in connection with the goodwill of a business in the goods lxvi 7 and there is sent herewith a copy of the Registrar's direction to advertise the assignment, a copy of each of the advertisements complying therewith, and a statement of the dates of issue of any publications containing them.