………………………………………… ………………………………………… ………………………………………… ……………………. ……………………. ……………………. Dated this ……………….….. day of …………..…………… , 200…… back of the form (4) Signature. (4) …………………………………………….. The Registrar The Trade Marks Office, P.O. Box 100 BLANTYRE LAWS OF MALAWI Trade marks Trade Marks Regulations Cap. 49:01 (Subsidiary) MALAWI Form TM. No. 16 Section 27. Regulation 71. TRADE MARKS ACT (CAP. 49:01) Fee: 9 or 9(a). Joint Request to the Registrar by Registered Proprietor and Transferee to register the Transferee as Subsequent Proprietor of Trade Marks upon the same devolution of title. We (1) ……………………………………………………………………………………. and (2) ……………………………………………………………………………………. hereby request, under regulation 71, that the name of (3) ………………………………. ……………………………………………………………………………………………. carrying on business as (4) ………………………………………………………………. at (5) ……………………………………………………………………………………… may be entered in the register of trade marks as proprietor of the trade mark(s) No. ……………………………………………. * in class ………………………………….. as from the (6) ……………………………………………………………………………. .(7) ……………………………………………………………………………………….. (1) State name and address of registered proprietor, or other assignor or transmitter. (2) State full name, trade address and nationality of transferee. (3) name transferee. of (4) Description of transferee. *Additional numbers may be given in a signed schedule on the back of the form. (5) Trade or business address of transferee. (6) Date acquisition of of