FORM 5





DESIGNS ACT, 1911



Appeal to Central Government Under Sec. 43 or 69 1[***l



2[FEE Rs.50]



I (or We) 3................................................................................................................hereby appeal to the Central Government from the decision (or that part of the decision) 4 Of the Controller dated the5........................................................ day of...........................19 where he:

6(j) Refused to register a design under Sec. 43:

(k) Refused to grant a registered design under Sec. 69;

The reasons for appealing and the full statement of the grounds upon which I (or we) rely for objecting to the decision are as follows7:

My address for service in India is:

………………………………………………………..

……………………………………………………………

……………………………………………………………

Dated this ................................................. day of..................19……........

(Signed)........................

* ** *** +.

++ must be dated and signed.

1. Omitted by the Patents Rules, 1972. rule 126. the Fifth Schedule.

2. Subs. by the Designs (Amendment) Rules. 1985 (w.e.f. 6th June. 1985).

3. Insert (in full) name and address of the applicant or applicants.

4. Strike out if not applicable.

5. The appeal must be made within 3 months of the date of decision.

6. Strike out what is not applicable

7. State fully continuing on further sheets and on one side only. The last page