Regulation 62(1) FORM TM-39 FEE: THE REPUBLIC OF UGANDA THE TRADE MARKS ACT, 2010. Application for the Certificate of the Registrar with reference to a Proposed Assignment of a Registered Trade Mark. (Regulation 62(1)) (To be accompanied by a Statement of Case in duplicate and a copy of the proposed assignment) IN THE MATTER OF Trade Mark(s) No. (s) ……..……registered in the name of ………………………..………………………………………….. in Class (es) ………………………………………………………………………. ……………………………………………………………………………….. Application is hereby made by (a)……………………………………….. of ……………………………………………………………………………. being the Registrar’s Certificate under section 31 (6) with reference to a (a) Here insert the name and trade business address of the Registered Proprietor. proposed assignment of the registered trade mark(s) No.(s) ………………….. ………………………… to (b)……………………………………………… ………………………………………………………………………………. of …………………………………………………………………………… (b) Here insert the name and trade business address of the proposed assignee. in circumstances that are fully in the accompanying Statement of Case. Dated this …………………day of …………………………..20 ……… (c)……………………………………………………………………………… To: Registrar of Trade Marks, P.O. Box 6848, Kampala 2073 (c) Signature