SECOND SCHEDULE - Form GI 2 (GEOGRAPHICAL INDICATIONS REGULATIONS 2001

P.U.(A) 247/2001
GEOGRAPHICAL INDICATIONS REGULATIONS 2001

SECOND SCHEDULE - Form GI 2

CENTRAL GEOGRAPHICAL INDICATIONS OFFICE MALAYSIA
GEOGRAPHICAL INDICATIONS REGISTRY

GEOGRAPHICAL INDICATIONS ACT 2000

GEOGRAPHICAL INDICATIONS REGULATIONS 2001

FORM OF AUTHORIZATION AND REQUEST TO ENTER, ALTER OR SUBSTITUTE AN ADDRESS FOR SERVICE

[Subregulations 12(1), (2), (3), (6) and 14(2)]

TO: The Registrar of Geographical Indications Central Geographical Indications Office Kuala Lumpur, Malaysia.

For Official Use:

Date of receipt by

Central Geographical Indications Office:

Fees received on:

Amount:

Applicant's or agent's file reference

1. Geographical Indication No.:

2. Class:

3. Full name and address of registered proprietor:

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Tel. No.:

Telegraphic Address:

Telex No.:

Fax No.:

4. Full name and address of agent (if any): ..................

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Agent's Registration No. (if known): ..................................................................

Agent's own reference: ..................................................................

Tel. No.:

Telegraphic Address:

Telex No.:

Fax No.:

5. I request that all communications concerning the above geographical indication be sent to the address indicated, which is the address for service.

Note: Enter (3) or (4) as appropriate in the box.

An address for service must be in Malaysia.

The full postal addresses of the parties must be given.

Signature:

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

Name of signatory (in block letters):

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

Date:

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