ADDITIONAL REPRESENTATION

 

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            

 

                  

 

1.           Name & Address of the Applicant

 

 

      

2.           Goods

 

3.           Class   

 

4.           Trade Description

 

5.           User

 

 

 

 

 

Signature