TRADE AND MERCHANDISE MARKS ACT, 1958
Representation Of Trade Mark
Name and address of the applicant : …………………………….	
 Address for service in India	: ………………………………
Class :	………………………………………………………..
Specification of Goods : ……………………… 	 
Period of Use :	……………………………..
…………. day of  ……….., 20………
For ………………………………
(By their Agents) 		
Address …………….
……………………….
……………………….