In the matter of Trade Mark(s) No(s)...........................................................registered in the name of ...................................................................in class (es)...................................
Application is hereby made by 1 ...............................................being the registered proprietor (s)
of the abovementioned registered trade mark(s) for the Registrar's certificate under section 40(2) with reference to a proposed assignment of the registered trade mark(s)
No.(s)................ to[2]............................ in circumstances that are stated fully in the accompanying statement of case.
All communications relating to this application may be sent to the following address in India:-
Dated this ................day of ...........20............
3............SIGNATURE
To
The Registrar of Trade marks,
The office of the Trade Marks Registry at [4].......................