Seal of the Board ……………………………………… The Kenya Copyright Board FORM NO. CR 3 (r. 9 (1)) THE COPYRIGHT ACT, 2001 THE KENYA COPYRIGHT BOARD APPLICATION TO AMEND NAME OR ADDRESS OF THE COPYRIGHT HOLDER Name and address of the copyright holder(s)/applicant(s) Physical address of the copyright holder(s)/applicant(s) Name and address of agent (if any) Application number Category of copyright work Copyright registration number (if any) I/We, the applicant(s) identified above apply to amend the following in the Copyright Register- The details of the requested amendment(s) are attached: Dated at …………………… this …………… day of ……………., 20 ….. Signature(s) ……………………… Applicant(s) FORM NO. CR4 (r. 9 (2))