96 TRADE MARKS REGULATIONS, 1970 (L.I. 667) .........................................................) in circumstances that are stated fully in the accompanying statement of case. 2. (e) ....................................................................................................................................... ...................................... of ....................................................................................................... who claims that the trade mark(s) shown in the accompanying statement of case was (were), in respect of the following goods, namely ................................................................................................................................. ....................................................................................................................................... ........................................ ....................................................................................................................................... ......................................... ....................................................................................................................................... ......................................... and on the(f) ............................................ day of ............................................. 19 .............................................. transmitted to (g) him (to) ................................................................................................ (h)............................... of .................................................................................................................................. ......................................... (who was his predecessor in title), by or fromi ....................................................................................................................................... ........................................ ....................................................................................................................................... ........................................ of.................................................................................................................................... ........................................ by whom the trade mark was then used in respect of the following goods, namely .................... all in circumstance that are stated fully in the accompanying statement of case, for the approval by the Registrar of the aforesaid transmission. Dated the ......................................................... day of ......................................., 19 .............................................