Trademarks Form Tm 21

FORM TM- 21 

THE TRADE MARKS ACT, 1999 

Age nt s  Code  N o: 

Pr opr ie t or s  Code No: 

Fee : Rs.500, 1,000 or 1,500 for extension of 1, 2 or 3 months respectively 

Application for extension of time in which to apply for the Registrar's direction for 
the advertisement of an assignment of trade marks otherwise than in connection 
with the goodwill of the business. 

Section 42 rules 74(3) 

Application is hereby made by ' ____________________.for extension of time of 2 _____________month(s) 
in which to apply for the Registrar's directions for the advertisement of an assignment of the 
following trade marks otherwise than in connection with the goodwill of the business in which 
they 3 (had been) (were) used, namely:- 

(I) Registered Trade Marks: 

*Registration Number Class 

-------------------------- Goods or services in respect of which the mark 

___________________________________. has been or is used and is assigned. 

___________________________________ 

all of which are or were registered in the name of 4__________of _________who is the assignor  

(II) Unregistered trade marks all being marks which 3 (had been)(were) used in his business 
in respect of the goods or services stated below, by 4 _________of_____________who is the assignor. 

*Representation of Mark Goods or services in respect of which the mark has been or is used 
and is assigned  

____________________________ 

The date of assignment was the _______________day of _______________20___________ 

All communications relating to this application may be sent to the following address in India. 

____________________.. 

____________________. 

Dated this ____________________day of _______________20___________ 

5___________________________  

SIGNATURE 

NAME OF SIGNATORY IN LETTERS 

To 

The Registrar of Trade Marks 

The Office of the Trade Marks Registry at 6_________________  

*Additional marks and registration numbers which cannot be accommodated here may be 
given in a signed schedule on back of the form. 

1. Inert the name and address of the assignee(applicant) 

2. Insert "one", "two", or "three" 

3. Strike out words not applicable 

4. Insert the name and address of the proprietor (assignor) 

5. Signature of applicant or of his agent 

6. State the name of the place of the appropriate office of the Trade Mark Registry. 

(See Rule 4).