IPIN/ lIN GA/D/ 1 Page 23 FORM DESIGNS (TEXTILES) FEE N37.80 NO.1 Patents and Designs Act Cap. 344 APPLICATION FOR REGISTRATION OF DESIGN FOR A TEXTILE ARTICLE OTHER THAN A DESIGN CONSISTING SUBSTANTIALLY OF CHECKS OR STRIPES ONLY (This application must be accompanied by an unstamped duplicate) Application is hereby made for registration of the accompanying design in the name of (a) . of . who claim(s) to be the proprietor(s) thereof. The design is to be applied to (b) . (c) The design has been previously registered for one or more other articles under No . .(d) The design consists of the design previously registered under No . ............ with modifications or variations not sufficient to alter the character, or substantially to affect the identity thereof. My (or Our) address for service in Nigeria is •• . 11" 111 DATED this day of (e) To The Registrar of Patents and Designs, Designs Registry (Textiles), Federal Ministry of Trade, Federal Capital Territory, Ahuja, Nigeria. 19 . . . N. B.-Four identical representations or specimens of the design should accompany this Form. (a) (b) (c) (e) Here insert (in full) the name, address and nationality of the applicant or applicants. Here state the article to which the design is to be applied. and (d) Strike out one or both paragraphs if inapplicable. Signature.