In the Matter of a Mark No. .................................................................... registered in Class ............................................................ in the name of clxiv 1 ..................................... ................................................................................................................................... ................................................................................................................................... and In the Matter of a registration of clxv 2 .................................................................................. ................................................................................................................................... thereunder as a Registered User of the Mark. In reply to the Registrar's Notification, dated the ......................... day of ........................., 20.........., notice is hereby given of my intention to intervene in the proceedings in the above matter. My address for service in Tanzania for the purpose of these proceedings is: ................................................................................................................................... ................................................................................................................................... Dated this ........................ day of ........................ 20........ clxvi 3 ....................................................................... To The Registrar of Trade/Service Marks, Dar es Salaam, Tanzania. i Cap. 326 The full name of all partners in a firm must be inserted, and the kind and country of incorporation of bodies corporate stated. iii Here state name and address of agent. iv Here state the particular matter or proceeding for which the agent is appointed giving the reference number if known. v Here state nationality. ii vi To be signed by a person appointing the agent. vii Here insert the full trade or business address of the person appointing the agent. viii Here state name and address of agent. ix To be signed by a person appointing the agent. x Here insert the full trade or business address of the person appointing the agent. xi One representation to be fixed within this space and two Others to be sent on separate Forms TM 3. xii One representation to be fixed within this space and two others to be sent on separate Form TM/SM 3. xiii Representations of a large size may be folded, but must then be mounted upon linen or other suitable material and affixed hereto. xiv Here specify the goods or services only or goods and services included in one and the same. xv Here insert legibly the full name, description and nationality of the individual, firm or body corporate making the application. The names of all partners in a firm must be given in full. If the applicant is a body corporate the kind and country of incorporation should be stated. xvi Here insert the full trade or business address of the applicant. xvii Here insert the trading style (if any). xviii If the Mark is already in use strike out the words; "proposed to be" and insert