Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1698841574601.pdf (Saint Vincent and the Grenadines)
SCHEDULE 2 INDUSTRIAL DESIGNS ACT 2005 Form No.

1 (regulation 10) APPLICATION FOR REGISTRATION OF AN INDUSTRIAL DESIGN I/We …................................................................................................................. .............................. ...........…............................................................................................................................................... (give name(s)) whose full postal address(es) is/are respectively ….
….............................................................. .............................................................................................................................................................. do hereby apply for the registration of an Industrial Design for .................................................. .............................................................................................................................................................. (kind of product) RELEVANT INFORMATION (use only those headings that are applicable) ADDRESS FOR SERVICE ......................................................................................................... ......
AGENT .............................................................................................................................................. (name and address) CREATOR(S) OF THE DESIGN- Complete only if accompanied by Form No.
2- name(s) and address(es) ............................................................................................................................................................. .............................................................................................................................................................

PRIORITY Indicate date and number of earlier application (s), the country where filed, and the name of the applicant (s) of the priority application (s).
I/We herewith submit or will submit within ninety days of the date of this application a certified copy of the earlier application (s) on which priority is based, and which is/are listed below: CLASSES OF PRODUCT (complete only if applicable) DESCRIPTION (give a short description of the visual features of the designs, indicating what parts of it are original) GRAPHIC REPRESENTATION (if supplied) A photograph, drawing or other graphic representation of the said Industrial Design is hereunto annexed SPECIMEN (if supplied) A specimen of the article-containing said Industrial Design is submitted herewith EXECUTION This application is executed on ............................................................................. at .....................................................................................................................................................… by (or on behalf of the applicant by) ...................................................................... (Signature) DATE SUBMITTED (indicate date when being sent to the Commerce and Intellectual Property Office) Note: the agent to make the application.
If this application is filed by an agent it must be accompanied by a power of attorney authorising INDUSTRIAL DESIGNS ACT 2005 Form No.
2 STATEMENT OF DESIGNER I/We.................................................................................................................................................... ............................................................................................................................................................... (give name (s) and address (es) of the designer (s)) do hereby declare that I/We created the Industrial Design for....................................................... ............................................................................................................................................................. (kind of product as stated in the application for registration) filed herewith, and request that my/our name (s) and address (es) be entered on the Register under section 8 (1) of the Act.
Signature (s) …............................................................................................. .............................................................................................… INDUSTRIAL DESIGNS ACT 2005 Form No.
3 APPOINTMENT OF AGENT The undersigned hereby appoints ............................................................................................. ... whose full postal address is …......................................................................................................... ................................................................................................................................................................ As agent, in respect of an application for an Industrial Design entitled and empowers the appointed agent to sign and amend the application, to prosecute it, to receive the registration certificate, to effect renewal, and to withdraw or surrender the application or registration, and ratifies any act done by the appointee in respect of the application or subsequent registration.
Signed at this …............... day of ….............................................. 20 .............. …......................................................................................... ….......................................................................................... (Signature (s)) INDUSTRIAL DESIGNS ACT 2005 Form No.

4 Registration No.
Date CERTIFICATE OF REGISTRATION OF AN INDUSTRIAL DESIGN THE COMMERCE AND INTELLECTUAL PROPERTY OFFICE SAINT VINCENT AND THE GRENADINES Whereas a request has been made to the Commerce and Intellectual Property Office for registration of an Industrial Design, particulars of which are attached hereto, and whereas such request has been found to comply with the Industrial Designs Act, 2005, now therefore be it known that said registration has taken place, granting to the owner all the benefits of the Industrial Designs Act.
The term of protection afforded by the registration is five years from the …............... day of ….............................................. 20 .............. Property rights arising from registration are subject to the conditions contained in the Industrial Design Act, and any adjudication of the High Court affecting those rights.

In testimony whereof this document bears the seal of the Commerce and Intellectual Property Office affixed to it at Kingstown.
Sealed this ….................. day of ….…............................ in the year …............. Registrar Commerce and Intellectual Property Office INDUSTRIAL DESIGNS ACT 2005 Form No.
5 TRANSFER AND ASSIGNMENTS OF APPLICATION FOR REGISTRATION I/We ….................................................................................................................................................. (name(s) and address(es)) …............................................................................................................................ ......................... … …........................................................................................................................................................... the owner(s) of an application for registration of a design for ….................................................... filed on ......................................................................................................….
do hereby transfer all my (our) rights in said design to …................................................................................................................................................................ ................................................................................................................................................................ [name(s) and address(es) indicate also nationalities, residences and any necessary address for service] Signed at …................................................................................................... on this …................day of …......................... ….in the year .................… by …............................................................................................................... (Signature of owner, agent or legal representative) and at .......................................................................................................….
on this ….............…day of …...................................in the year ............… by …............................................................................................................... (Signature of new owner or his agent or legal representative) The prescribed fee of $ ............….for recording this transfer is submitted herewith Name and address of new owner’s representative for service …............................................... …... …............................................................................................................................... ..................
Note: this form may be modified to make a partial transfer by specifying what is transferred INDUSTRIAL DESIGNS ACT 2005 Form No.
6 TRANSFER AND ASSIGNMENTS OF A REGISTERED DESIGN I/We …....................................................................................................................... ........................... (name(s) and address(es)) …................................................................................................................................. .................... … …........................................................................................................................................................... the registered owner(s) of Industrial Design No …........................... for a design for …................................................................................... registered on ........................................................................................… do hereby transfer all my (our) rights in said design to .... ….................................................................................................................................................... ... ..................................................................................................................….................................... (name(s) and address(es) indicate also nationalities, residences and any necessary address for service] Signed at ….............................................................................................................. (place) on this .............…..day of ….................................................. in the year …... ….. by …......................................................................................................................... ... (Signature of owner, agent or legal representative) and at ........................................................................................................................... on this .............…..day of ….................................................. in the year …... ….. by …........................................................................................................................... (Signature of new owner or his agent or legal representative) The prescribed fee of $ ….......for recording this transfer is submitted herewith, and we request that the transfer be registered Name and address of new owner’s agent …............................................................................. … (Name and address of new owner’s representative for service) ............................................... ….........................................................................................................................................................
Note: this form may be modified to make a partial transfer by specifying what is transferred INDUSTRIAL DESIGNS ACT 2005 Form No.
7 CHANGE OF NAME I/We …....................................................................................................................... ........................... (name(s) and address(es)) …..................................................................................................................................................... … …............................................................................................................................ ............................... the owner (s) of the application for registration of an industrial design or the registered design identified below wish to have recorded a change in name to ….................................... (name(s) and address(es)) ….................................................................................................................................................. ….. …............................................................................................................................ ............................
The prescribed fee of $ …......for registering the change of name is submitted herewith Registration No ….

…...

Date registered ….........................................................................................

Date application filed …..............................................................................

Title of design …..........................................................................................
Signed at …................................................................................................... on this …................ day of ........................................ in the year …......... by .............................................................................................................….. (Signature of owner or agent) INDUSTRIAL DESIGNS ACT 2005 Form No.
8 RENEWAL OF REGISTRATION OF AN INDUSTRIAL DESIGN (UNDER SECTION 10 (1) OF THE ACT) I/We ….................................................................................................................................................. (name(s) and address(es)) …............................................................................................................................ ......................... … …........................................................................................................................................................... the registered owner(s) of the Industrial Design No …................................ hereby forward the prescribed fee for the renewal of the said Design in accordance with section 10 (1) or (3) of the Act.
Note: This form must be submitted in duplicate.

INDUSTRIAL DESIGNS ACT 2005 Form No.
9 REQUEST FOR CERTIFICATE OF THE REGISTRAR IN RELATION TO AN ENTRY, MATTER OR THING IN THE MATTER OF1 the Industrial Designs Act, 2005 I/We …....................................................................................................................... ........................... (name(s) and address(es)) …..................................................................................................................................................... … …........................................................................................................................................................... hereby request the Registrar to furnish me(us) with2 …............................................................. ................................................................................................................................................................
Dated this …............ day of ..........................................…... 20 …............. 3 …........................................................ 4 .......................................................................................................................… ........................................................................................................................... To the Registrar Commerce and Intellectual Property Office Kingstown __________________________ Note: 1 These words may be altered to suit other circumstances.
2 Here set out the particulars that the Registrar is requested to certify.

3 Signatures.

4 Address.

Made this day of 2008.

Dr. Hon.

Ralph E. Gonsalves Prime Minister and Minister of Finance, Economic Planning, National Security, Public Service, Legal Affairs and Grenadines Affairs