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Designs Act, 1993 (Act No. 195 of 1993)

Regulations

Designs Regulations, 1999

Schedule 2 : Form D13

 

 

Form D13

Application for the voluntary surrender of a registered design

(Section 34 - Regulation 42)

(Lodge in duplicate)

 

Design No.:

Date of lodgement



 

 

Full name(s) of registered proprietor(s):

 

 



 

 

Class:

 

Type of design

Part A

Part F

 

I / We ...................................................................................................................................................................................................................................

.............................................................................................................................................................................................................................................

 

hereby declare that-

 

1.

(a)

I/we am/are the proprietor(s) mentioned above;

1.

(b)

I/we am/are authorised by the proprietor(s) to make this offer;

2.

I/We hereby offer to surrender the above-mentioned design registration;

3.

no action for infringement or proceedings for revocation of the design are pending except as set out below; and

........................................................................................................................................................................................................................................................

........................................................................................................................................................................................................................................................

4.

the reasons for making this offer are as follows:

........................................................................................................................................................................................................................................................

........................................................................................................................................................................................................................................................

 

 

Date:

 

______________________________________________

APPLICANT/APPLICANT'S AGENT

 

Address for service:

 

 

 

 

FOR OFFICIAL USE ONLY

The above offer to surrender has been allowed/refused

Official date stamp

 

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