CC8 Application for reservation of a name Application for Reservation of a Name or Translated Form or Shortened Form

Application for Reservation of a Name or Translated Form or Shortened Form

(To be lodged in duplicate)

Business and Intellectual

Property Authority - BIPA

Registrar of Business Office

PO Box 185

WINDHOEK

NAMIBIA

Tel: +264 61 2994400

Email: info@bipa.na

N$ 75,00 fee payable in terms of the Act and as set out in the regulations

A

Proposed Name

or Translated Form

or Shortened From

(indicate with a cross)

In order of preference

For Office Use

signature & Date

1.

approved/not approved

2.

approved/not approved

3.

approved/not approved

4.

approved/not approved

5.

approved/not approved

6.

approved/not approved

Reservation is valid for sixty days

B.

Comparative names (For Office Use)

C.

Is the proposed name associated with a person, corporation or company? If so, what is the name and number (if a corporation or company) and the nature of the association. If not, reason(s) for, or origin of name.

D.

Principle business of the corporation/proposed corporation

Name of Applicant (print)

Signature of applicant/agent

Address to which form must be returned

Postal Address:

Date

E-mail Address:

Mobile Number:

Telephone Number:

REPUBLIC OF NAMIBIA

CC 8

BUSINESS AND INTELLECTUAL PROPERTY AUTHORITY - BIPA

CLOSE CORPORATIONS ACT,1988

(Section 19(2))