Regulations 74(2) and 75 FORM TM-23 FEE: THE REPUBLIC OF UGANDA THE TRADE MARKS ACT, 2010. Request by Registered Proprietor of a Trade Mark that a Disclaimer or Memorandum relating thereto may be registered. (Regulations 74(2) and 75) To: Registrar of Trade Marks, P.O. Box 6848, Kampala. Request is hereby made by (a) ………………………………………………… ………………………………… of …………………………………………. …………………………………………………………………………………. (a) Here insert the name, trade or business address and description of the Registered Proprietor. for the addition to the entry in the Register in connection with Trade Mark No. ……………………… in class ……………..…………. of the following …………………………………………………………………………………. …………………………………………………………………………………. …………………………………………………………………………………. Dated this ……………… day of ……………………………………, 20…… (b) …………………………………………………. Applicant 2058 (b) Signature.