IPIN/lINGA/T/2 Page 60 13 TRADE MARKS ACT (FEE STAMP-ITEM 11 c) Additional Fee to accompany Renewal Fee (Form 12) within one month after advertisement of Non-payment of Renewal Fee (To accompany Form 12) FORM In pursuance of the notices issued by the Registrar, I (or we) hereby transmit the additional fee (along with Form 12) for the renewal of the Registration of the trade Mark No. . Class . DATED this day of (c) (d) In ,19 . . . To: The Registrar of Trade Marks, Federal Ministry of Trade and Tourism, Abuja, Nigeria. N.B.-This Form must be signed by the person(s) signing the Form 12 which accompanies it. (a) Signature. (b) Address.

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