IPINIIINGA/T/2 Page 49 FORMS 1 TRADE MARKS ACT Form of Authorisation of Agent in a matter or proceeding under the Act (Regulation 16) FORM *1 (or We) . have appointed (a) of . . to act as my (or our) agent for (b) .. .......................................... No . and request that all notice, requisitions and communications relating thereto may be sent to such agent at the above address. I (or We) hereby revoke all previous authorisations, if any, in respect of the same matter or proceeding. I (or We) hereby declare that I am (or we are) a (c) . DATED this day of ,19 .. (d) . Address (e) . (To be struck out if the person appointing the Agent desires hIS own address to be treated as the address for service after registration) I (or We) also authorise the said (a) . to complete Form 33 requesting the entry of an address for service as part of any registration obtained under the above authorisation. DATED this (d) Address (e) day of ,19 .. . . To: The Registrar of Trade Marks, Federal Ministry of Trade and Tourism, Abuja, Nigeria. *The full name of all the partners in a firm must be inserted, and the kind and country of incorporation of bodies corporate stated. (a) Here insert name and address of agent. (b) Here state the particular matter or proceeding for which agent is appointed, giving the reference number, if known. (c) Here state nationality. (d) To be signed by the person appointing the agent. (e) Here insert the full trade or business address of the person appointing the agent.