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BEFORE THE INTELLECTUAL PROPERTY APPELLATE BOARD Fee Rs.3,000 FORM 4 APPEAL
UNDER SECTION 91 OF THE TRADE MARKS ACT, 1999 READ WITH RULE 162 OF THE TRADE
MARKS RULES, 2002 IN RESPECT OF REGISTRATION OR REMOVAL OF A TRADE MARKS AGENT
FROM THE REGISTER OF TRADE MARKS AGENTS (To be filed in triplicate) Title of the Case: INDEX Sl.No.
Description of documents relied upon
Page No. 1. 2. 3. 4. Signature of the Appellant For use in the Board Office Date of filing Registration No. Signature BEFORE
THE INTELLECTUAL PROPERTY APPELLATE BOARD A.B. (add description such as
full name, nationality, address, registered office
) APPELLANT
Vs. RESPONDENT
(Particulars of the order giving the details like the number, date and
authority which has passed the order against which the appeal is made.) 2. Jurisdiction
of the Board: The appellant declares that the subject matter of the order against which
he wants redressal is within the jurisdiction of the Board. 3. Limitation: The appellant further declares that the appeal is within the limitation
period prescribed in section 91(1) of the Trade Marks Act, 1999. 4. Facts
of the case: (Give here a concise statement of facts in a chronological order, each
paragraph containing as nearly as possible a separate issue or fact.) 5. Grounds
for relief with legal provisions: 6. Matters
not previously filed or pending with any other court: The appellant shall declare that he had not previously filed any appeal,
writ petition or suit before any court or any other authority regarding the
matter in respect of which this appeal has been made. In case the appellant had previously filed any such appeal, writ petition
or suit, the stage at which it is pending, and if decided, the list of the
decisions should be given with reference to the number of Annexure to be given
in support thereof. 7. Reliefs
sought: In view of the facts mentioned above
the appellant prays for the following relief(s): (Specify the relief(s) sought
explaining the grounds for such relief(s) and the legal provisions, if any
relied upon). 8.
Particulars of Bank Draft 9.
List of enclosures: 1. 2. 3. 4. 10.
All communications relating to these proceedings may be sent to the
following address in India:-
. VERIFICATION
I
(Name of the appellant) age
of
.
nationality, resident of
do hereby verify
that the contents of paras
. to
. are true to my
personal knowledge and paras
to
.. are
believed to be true on legal advice
and that I have not suppressed any material fact. Dated, this
.day
of
.. Place: Signature
of the Appellant To,
The Deputy
Registrar, |