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Malaysia Legislation


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



SECOND SCHEDULE - Form GI 11

CENTRAL GEOGRAPHICAL INDICATIONS OFFICE MALAYSIA
GEOGRAPHICAL INDICATIONS REGISTRY
GEOGRAPHICAL INDICATIONS ACT 2000

GEOGRAPHICAL INDICATIONS REGULATIONS 2001


    REQUEST FOR REGISTRAR'S CERTIFICATE OTHER THAN CERTIFICATE OF REGISTRATION
    [Regulation 34]


    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 Number in respect of which a certificate is required.
    2. Class:
    3. Certificate requirements:

    Set out below the particulars which the Regular is requested to certify.
Note: A representation of the geographical indication will not be included in any certificate issued in response to this request unless one copy suitable for the purpose is supplied to the Registrar.
    4. Name and address to which the certificate is to be sent:

    Signature: ..................................................................

    Name of signatory (in block letters): ..................................................................

    Date: ..................................................................