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Name of Application Firm/Company/Trust/Individual |
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Address of Applicant |
|
Type of Organization |
Proprietorship
Registered Partnership
Registered Company
Trust
Association H.U.F |
Full Name of Signatory
(On Behalf of Firm/Company/Trust/Individual) |
|
Designation of Signatory |
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Nationality of Signatory |
|
Father's, Husband's Name of Signatory |
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Phone No. |
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Email ID |
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Residence Address of Signatory |
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Age of Signatory |
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Significance of the Mark, Brand Name |
|
Goods, Services (Exact) |
|
Goods, Services (Exact) |
|
Goods, Services (Exact) |
|
Trade Description |
Manufacturer
Dealer
Trader
Merchant
Service Provider |
User Date |
|
Date |
|
Place |
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Electronic Signature as Full Name |
|
|
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