1872
THE NEW ZEALAND GAZETTE.
[No. 50

[Form No. 6.

Stamp, 10s.
(Leave uncanceled.)

The Patents, Designs, and Trade-marks Act, 1911.

APPLICATION FOR EXTENSION OF COPYRIGHT FOR THE THIRD PERIOD OF FIVE YEARS.

I, __, the registered proprietor of Design No. __ in Class __, hereby apply that the copyright in the design in question may be extended for a third period of five years in accordance with the provisions of section 52 (3) of the Patents, Designs, and Trade-marks Act, 1911.

[Signature.]
[Address.]

Dated this __ day of __, 19 __.
To the Registrar, Patent Office, Wellington, New Zealand.

[Form No. 7.

Stamp for treble amount of fee on original application.
(Leave uncanceled.)

The Patents, Designs, and Trade-marks Act, 1911.

EXTENSION OF COPYRIGHT IN DESIGN FOR THE THIRD PERIOD OF FIVE YEARS.

IN accordance with your notice of the __, the prescribed fee for the extension of the copyright in the Design No. __ in Class __, for a third period of five years is hereby lodged.

Dated this __ day of __, 19 __.
To the Registrar, Patent Office, Wellington, New Zealand.
(N.B.—This form must be indorsed with the name and address of the person lodging the same.)

[Form No. 8.

Stamp for same amount of fee as on application.
(Leave uncanceled.)

The Patents, Designs, and Trade-marks Act, 1911.

JOINT REQUEST BY REGISTERED PROPRIETOR AND ASSIGNEE OR MORTGAGEE OR LICENSEE, ETC., TO ENTER THE NAME OF ASSIGNEE, ETC., IN THE REGISTER OF DESIGNS.

WE, [Name of registered proprietor], of [Address of registered proprietor], and [Name of assignee, &c.], of [Address of assignee, &c.], hereby request that the name of [Name of assignee, &c.] carrying on business as [Trade or business of assignee, &c.], at [Business address of assignee, &c.], may be entered in the Register of Designs as proprietor [or mortgagee, or licensee, or as the case may be] of the Design No. __ in Class __.

Dated this __ day of __, 19 __.
[Signature of registered proprietor.]
[Signature of assignee, &c.]

To the Registrar, Patent Office, Wellington, New Zealand.

[Form No. 9.

Stamp for same amount of fee as on application.
(Leave uncanceled.)

The Patents, Designs, and Trade-marks Act, 1911.

REQUEST TO ENTER NAME OF SUBSEQUENT PROPRIETOR, OR OF MORTGAGEE, OR OF LICENSEE, ETC., OF DESIGN, IN THE REGISTER.

I [or WE] [Here insert name, address, and calling] hereby request that you will enter my [our] name[s] in the Register of Designs as proprietor [or mortgagee, or licensee, or as the case may be] of the Design No. __ in Class __.

I am [We are] entitled __ to the said design.
Accompanying this request is a statement of my [our] case.

[Signature.]

Dated this __ day of __, 19 __.
To the Registrar, Patent Office, Wellington, New Zealand.

[Form No. 10.

The Patents, Designs, and Trade-marks Act, 1911.

FORM OF DECLARATION (TO BE FURNISHED ONLY WHEN REQUESTED BY REGISTRAR) IN SUPPORT OF STATEMENT OF CASE ACCOMPANYING FORM NO. 9.

I, __, of __, do hereby solemnly and sincerely declare that the particulars set out in the statement of case, exhibit marked __, and left by me in connection with my request to be registered as __ of the Design No. __ in Class __, are true and comprise every material fact and document affecting the above claim.

And I make this solemn declaration conscientiously believing the same to be true, and by virtue of the Justices of the Peace Act, 1908.

[Signature of the person making the declaration.]

Declared at __, this __ day of __, 19 __, before me—[Signature and title of the authority before whom the declaration is made].

To the Registrar, Patent Office, Wellington, New Zealand.

[Form No. 11.

Stamp, 1s.
(Leave uncanceled.)

The Patents, Designs, and Trade-marks Act, 1911.

FORM OF APPLICATION UNDER RULE 38 TO VACATE ENTRY OF NAME OF MORTGAGEE OR LICENSEE IN REGISTER.

Design No. __, Class __.
Name of registered proprietor: __.
Place of business: __.
Description: __.

I, THE undersigned, __, of __ [or I, the undersigned, __, a member of the firm of __, of __, on behalf of my said firm] apply that the entry of my [our] name in the Register of Designs as __ of the Design No. __ in Class __ may be vacated.

[Signature.]

Dated this __ day of __, 19 __.
To the Registrar, Patent Office, Wellington, New Zealand.

[Form No. 12.

Stamp, 1s.
(Leave uncanceled.)

The Patents, Designs, and Trade-marks Act, 1911.

APPLICATION FOR ALTERATION OF ADDRESS, OR ADDRESS FOR SERVICE, IN REGISTER OF DESIGNS.

Design No. __, registered in Class __.

I, __, of __, the registered proprietor of the design numbered as above, apply that my address [or my address for service] in the Register of Designs may be altered to __.

Dated this __ day of __, 19 __.
[Signature of Proprietor.]

To the Registrar, Patent Office, Wellington, New Zealand.

[Form No. 13.

Stamp, 1s.
(Leave uncanceled.)

The Patents, Designs, and Trade-marks Act, 1911.

FORM OF REQUEST FOR CORRECTION OF CLERICAL ERROR IN AN APPLICATION TO REGISTER, OR FOR CORRECTION OF CLERICAL ERROR UNDER SECTION 108.

I HEREBY request that __.

[Signature.]
[Address.]

Dated this __ day of __, 19 __.
To the Registrar, Patent Office, Wellington, New Zealand.

[Form No. 14.

Stamp, 1s.
(Leave uncanceled.)

The Patents, Designs, and Trade-marks Act, 1911.

FORM OF APPLICATION BY REGISTERED PROPRIETOR OF DESIGN TO CANCEL ENTRY IN REGISTER.

Design No. __, Class __.
Name of registered proprietor: __.
Place of business: __.
Description: __.

I, THE undersigned, __, of __ [or I, the undersigned, __, a member of the firm of __, of __, on behalf of my said firm] apply that the entry in the Register of Designs of the Design No. __ in Class __ may be cancelled [or cancelled in respect of __].

[Signature.]

Dated this __ day of __, 19 __.
To the Registrar, Patent Office, Wellington, New Zealand.