In the matter of Trade Mark No.......................Class.....................
Name of registered proprietor ........................
Address as entered in the register..................
Application is hereby made by the aforesaid registered proprietor that the entry in
the Register of Trade Marks of Trade Mark No...........in class ........may be cancelled.
1A copy of the application has been served on the Registered User(s)
All communications relating to this application may be sent to the following address in India:-
Dated this ................day of ...........20............
2............SIGNATURE
To
The Registrar of Trade marks,
The office of the Trade Marks Registry at 3.......................