e-form

Application for Full or Partial Surrender of the Goods or Services for which the Mark Is Registered or Withdrawal of a Trademark

WARNING to all applicants - Any false statements, misrepresentation or concealment of material fact on this form or any document presented in support of this application may be grounds for criminal prosecution.

INFORMATION PROTECTED – The Commerce Department within the Ministry for the Economy and Industry collects and processes the personal data provided in this application to carry out its lawful functions under the Trademarks Act [Cap.597].

All personal data is collected and processed in accordance with the General Data Protection Regulation 2016/679 and all current Data Protection legislation, the Trademarks Act [Cap. 597] and the Data Privacy Policy of the Department, a copy of which is available on our website.

Personal data provided in this application will only be shared with third parties according to the law.

Details of Registration / Application

Trademark Number





Class





Details of Applicant

Full Name





Address





Postcode





Country





Telephone Number





Mobile Number





E-Mail





FOR OFFICE USE ONLY:

Receipt No.& Date:

Amount Paid:

Page 1



Print Form
pageno Next Page


 


Aloaha Software
Aloaha Form Provider