In the matter of 1............................................................................
I (or we)2 .................................................... being the ....................... in the above matter hereby apply to the Registrar for the review of his decision dated the ............. day of ...........20..........., in the above matter.
The grounds for making this application are set forth in the accompanying statement
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