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(To be filed in triplicate along with the statement of case in triplicate together with an affidavit)
In the matter of trade mark No
pending/registered in the name of
. In class
.
A. I/We
.hereby apply that the pending trade mark No
..in class
in the name of
be refused registration on the following grounds
..
B. I/We
.hereby apply that the entry in the register in respect of the abovementioned trade mark may be removed/rectified in the following manner
.
The ground(s) of my/our request is/are as follows:
...
The appropriate office of the Trade Marks Registry at
is the appropriate office.
The affidavit to accompany the statement of case shall declare that the particulars set out in the statement are true and comprise every material facts concerning the trade mark which contains or consists of a geographical indication not originating the territory of a country, or a region or locality in that territory with such geographical indication indicates and which is likely to cause confusion or mislead persons as to the true place of origin of such goods or class or classes of goods within the meaning of section 25(a) of the Geographical Indication of Goods (Registration and Protection) Act, 1999 to the best of knowledge, information and belief of the deponent.
All communication to this request may be sent to the following address in India
.
Dated this .............day of ......20..........
SIGNATURE ..
To
The Registrar of Trade marks,
The office of the Trade Marks Registry at
..
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