The Laws of Zambia REPUBLIC OF ZAMBIA Designs Form No. 4 Sections 9 and 13 Regulations 3 and 11 THE REGISTERED DESIGNS ACT Fee: 1 (b) APPLICATION UNDER SECTION 13 OF THE ACT FOR REGISTRATION OF DESIGN TO BE APPLIED TO A SET OF ARTICLES (CONVENTION) Application is hereby made for the registration of the accompanying design in the name of (1) ............................................................................................................................................................................................ .................................................................................................................................................................................................... of ................................................................................................................................................................................................ (1) Stat name a addres applica being a national/nationals of ...................................................................................................................................................... who claim(s) to be the proprietor(s) thereof (2) .......................................................................................................................... .................................................................................................................................................................................................... .................................................................................................................................................................................................... .................................................................................................................................................................................................... .................................................................................................................................................................................................... The design is to be applied to a (3) .................................................................................................................................. .................................................................................................................................................................................................... .................................................................................................................................................................................................... .................................................................................................................................................................................................... .................................................................................................................................................................................................... (2) If th applica the per who ma applica the con country words " virtue o followe particu the inst under w he claim should inserte (3) Her the set articles No. ......................................... also the (5) The design consists of the design previously registered under No. ............................................................................ descrip with modifications or variations not sufficient to alter the character or substantially to affect the identity thereof. each of articles Application for protection of the design has been made in the following country compri (6) ...................................................................................................................................................................................... the set on the following official date (7) .................................................................................................................................................. which t design numbered (8) ............................................................................................................Such application was the first application applied made in a convention country in respect of the relevant design, whether by the applicant(s) or by any person of whom shown he/they claim(s) to be the legal representative(s) or assignee(s), and the applicant(s) in the above mentioned country represe qualify/qualifies under (9) Article 2/3 of the Convention by reason of being (9) a national(s) of/domiciled in/having a place of (4) The design has been previously registered for one or more other articles under business in a member state, namely .......................................................................................................................................... This application is made on the ground that I/we qualify under the said (9) Article 2/3 by reason of being (9) a national(s) of/domiciled in/having a place of business in a member state, namely .............................................................................................................................................................................. and that to the best of my/our knowledge and belief there is no lawful ground of objection to the registration of the design and that I/we request that the design may be registered as of the date (7) .............................................................................................................................................................................. Dated this ..............................................................................................day of .........................................., 19 ............... Copyright Ministry of Legal Affairs, Government of the Republic of Zambia (4) and Delete both paragra inapplic