(To be filed in triplicate accompanied by a statement in triplicate of the grounds for the application and the written consent in triplicate (if given) of the registered user)
Application is hereby made by 1 ........................the proprietor of trade mark(s) No.2 ................. registered in class................in respect of 3 ..................that the registration of 4 .....................as a registered user of the abovementioned trade mark(s) in respect of 5 ................may be varied in the following manner6.:-
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All communications relating to this application may be sent to the following address in India:-
Dated this ................day of ...........20............
7............SIGNATURE
To
The Registrar of Trade marks,
The office of the Trade Marks Registry at 8.......................