67 TRADE MARKS REGULATIONS, 1970 (L.I. 667) in Class ............................................................... may be cancelled. Dated this ...........................................................day of ........................................19.................................................... (Signature)................................................................. To The Registrar of Trade Marks, Registrar-General's Department, P.O. Box 118, Accra. _______________ (a) Here insert the trade or business address and description of the applicant(s) of his (their) firm. Form TM—No. 21 TRADE MARKS REGULATIONS, 1970 Fee: N ¢ 2.00 APPLICATION BY REGISTERED PROPRIETOR OF TRADE MARK TO THE REGISTRAR TO STRIKE OUT GOODS FROM THOSE FOR WHICH THE TRADE MARK IS REGISTERED (Paragraph (d) of section 34 (1) and regulation 44 (1)) IN THE MATTER OF Trade Mark ......................................................................................................................... No. registered in Class.............................................................................................................................. ................................. Name of Registered Proprietor....................................................................................................................... ....................

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