UGANDA REGISTRATION SERVICES BUREAU FORM 13 APPLICATION FOR GRANT OF LICENCE To: The Owner of Copyright/ Agent of Owner of Copyright P.O Box ………………… 1 Title of work …………………………………………………………… 2 Nature or category of work…………………………………………….. 3 Owner of the copyright or neighbouring rights, present on record / Agent of Owner: (a) Name…………………………………………………………… (b) Address…………………………………………………………… (c) Nationality……………………………………………………… Applicant for Licence: (a) Name…………………………………………………………… (b) Address…………………………………………………………… (c) Nationality……………………………………………………… Purposes for which licence is sought: (a) ………………………………………………………………….. (b) ……………………………………………………………………. (c) ……………………………………………………………………. Signature of applicant Licensee………………………………………… FOR OFFICIAL USE Date received …………………………. 24