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

Regulations

Purchase

Form D18

Request for certificate or copy

(Section 23 - Regulation 35)

(Lodge in duplicate)

Design application/registration No		Date of lodgement

Full name(s) of registered proprietor:

Full address(es) of registered proprietor(s):

Class:

Type of design

Part A

Part F

1.	I/we hereby apply for the restoration of the above-mentioned design registration.

2.(a)

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

2.(b)

I am/we are authorised to represent the above-mentioned proprietor(s) in this application.

3.	The circumstances under which the design registration lapsed and the grounds on which restoration is requested are set out in the accompanying affidavit(s).

Date:

APPLICANT/APPLICANT'S AGENT

Address for service:

FOR OFFICIAL USE ONLY

Official date stamp

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

1.	Lodgement of this document/accompanying document(s) acknowledged.

2.	The above application is to be published in the journal.

3.	The above application has been allowed/refused.