MINISTRY OF COMMERCE KINGDOM OF CAMBODIA
Kingdom of Cambodia
Nation - Religion – King
3
To: Department of Intellectual Property Rights
Ministry of Commerce
REQUEST FOR RECORDAL OF ASSIGNMENT
OF REGISTERED MARK
1. Mark:
2. Class(es):
3. App. No(s):
4. Reg. No(s):
5. Name and Address of Assignor:
6. Name and Address of Assignee:
7. Name of Local Agent/Attorney and Address for Service:_______________________
_______________________________________________________________________
Tel: ______________ Fax: _________________ Email: _______________________
8. Documents accompanying the application:
- Original or Certified Copy of notarized Deed of Assignment
- Original Notarized Power of Attorney and Deed of Substitution, if the Agent/Attorney is newly appointed.
- Original Mark Registration Certificate(s)
Signature: __________________________
Name of Signatory: _____________________
[Stamp]
Title: __________________________
Date: __________________________
-----------------------
Form: 011-RRARM-Eng
CAMBODIA
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