Signature ………………………… Executive Director The Kenya Copyright Board. FORM NO. CR 14 (r. 15 (3)) THE COPYRIGHT ACT, 2001 THE KENYA COPYRIGHT BOARD APPLICATION FOR RENEWAL OF REGISTRATION OF A COLLECTING SOCIETY Name and address of collecting society Physical address Name and address of agent (if any) Date of registration Class of copyright owners Application number Registration number Any change which occurred during the past year (use a separate sheet, if necessary) We hereby apply for renewal of the registration of the society as a collecting society for the period ………………………………… We attach hereto a certified copy of our audited accounts for the year 20 …………… Dated at …………………… this …………… day of ………………., 20 ….. Seal of the Society Signature(s) .......................................

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