WORLD TRADE ORGANIZATION 
ORGANISATION MONDIALE DU COMMERCE 
ORGANIZACION MUNDIAL DEL COMERCIO 
Council for Trade-Related Aspects 
of Intellectual Property Rights JP /N/IITTO/L/2 
29 March 2000 
(00-1272) 
Original: English/ 
anglais! 
ingles 
MAIN DEDICATED INTELLECTUAL PROPERTY 
LAWS AND REGULATIONS NOTIFIED UNDER 
ARTICLE 63.2 OF THE AGREEMENT 
TRINIDAD AND TOBAGO 
The present document reproduces the textl of the Layout-Designs (Topographies) of 
Integrated Circuits Rules 1996, as notified by Trinidad and Tobago under Article 63.2 of the 
Agreement (see document IP/N/1/TTO/l). 
Conseil des aspects des droits de propriete 
intellectnelle qui touchent au commerce 
PRINCJP ALES LOIS ET REGLEMENTATIONS CONSACREES A LA 
PROPRIETlt INTELLECTUELLE NOTIFIEES AU TITRE 
DE L'ARTICLE 63:2 DE L'ACCORD 
TRINITE-ET-TOBAGO 
Le present document contient le textel des Regles de 1996 relatives aux schemas de 
configuration (topographies) de circuits integres, notifiees notifieepar la Trinite-et-Tobago au titre de 
l'article 63:2 de l'Accord (voir le document IP/NIlITTOI 1 ). 
Consejo de los Aspectos de los Derechos de Propiedad 
Intelectual relacionados con el Comercio 
PRINCJPALES LEYES Y REGLAMENTOS DEDICADOS A LA 
PROPIEDAD INTELECTUAL NOTIFICADOS EN VIRTUD 
DEL P ARRAFO 2 DEL ARTiCULO 63 DEL ACUERDO 
TRINIDAD Y TABAGO 
En el presente documento se reproduce el textol del Reglamento de Esquemas de Trazado 
(Topografias) de los Circuitos Integrados, 1996, notificado por Trinidad y Tabago en virtud del 
parrafo 2 del articulo 63 del Acuerdo (vease el documento IP/N/1/TTOIl). 
I In English only'/En anglais seulement.lEn ingIes solamente. IP/N/lITTO/L/2 
Page 2 
LEGAL NOTICE No. 157 
REPUBLIC OF TRINIDAD AND TOBAGO 
THE LAYOUT-DESIGNS (TOPOGRAPHIES) OF INTEGRATED 
CIRCUITS Acr, 1996 
RULES 
MADE BY THE MINISTER IN ACCORDANCE WITH SECTION 20 OF THE 
LAYOUT-DESIGNS (TOPOGRAPHIES) OF INTEGRATED CIRCUITS Acr, 1996 
THE LAYOUT-DESIGNS (TOPOGRAPHIES) OF INTEGRATED 
CIRCUITS RULES, 1996 
1. These Rules may be" cited as the Layout-Designs (Topographies) Citation 
of Integrated Circuits Rules, 1996. 
2. In these Rules unless"the context Dthen'lise requires, "section"Interpreta-
refers to the specified section of the Act: tion 
3. The fees to be paid in respect of matters arising under the Act of Fees 
these Rules shall be those specified in the Schedule of Fees in 
Schedule 1. Schedule I 
4. (1) The forms referred to in these Rules are those set out inForms 
Schedule n. Schedule II 
(2) A requirement under these Rules to use such a form is 
satisfied by the use either of a replica of that form or of a form which is 
acceptable to the Controller and contains the information required by 
the form set out in that Schedule. 
5. Applications shall be in the English language, and any document Language of 
forming part of an application or submitted to the Controller pursuant ~~~umenta 
to the Act or these Rules and which is in a language other than English transactions 
shall be accompanied by an English "transl.ation verified by the 
translator that the translation is to the best of his knowledge complete 
and faithful. 
6. (1) Names of natural persons shall be indicated by the person's Indication of 
family's name and given name or names, residence indicated before the ~~::~9 . 
given name or names and the names of legal entities shall be indicated nationality 
by their full, official designations. IP/N/lITTO/L/2 
Page 3 
(2) Address shall be indicated in such a way as to satisfy the 
customary requirements for prompt postal delivery at the indicated 
address and, in any case, shall consist of all the relevant administrative 
units, including the house number, if any, and addresses shall also 
indicate telegraphic and telex addresses and facsimile and telephone 
numbers. 
(3) Nationality shall be indicated by the name of the State of 
which a person is a national and legal entities shall indicate the name 
of the State under whose laws they are constituted and the address of 
their registered office. 
(4) 'Residence shall be indicated by the name of the State of 
which a person is a resident. 
Signatures by 7. (1) A document purporting to be signed 'for or on behalf of a 
partne~hips. , partnership shall contain the names of all the partners in full and shall companies 
and be signed by all the partners or by any partner qualified to sign, stating 
associations that he signs on behalf of the partnership, and or by any other person 
Representa. 
tion by 
attorney-at­
law 
Application 
for 
registration 
of layout­
design who satisfies the Controller that he is authorized to sign the document 
and a document purporting to be signed for or on behalf of a body 
corporate shall be signed by a director or by the secretary or other 
principal officer of the body corporate, or by any' other person who 
satisfies the Controller that he is authorized to sign the document and 
shall bear the seal of the body corporate and a document purporting to 
be signed for or on behalf of an associatipn of persons may be signed by 
any person who satisfied the Controller that he is duly authorized. 
(2) The Controller may, whenever he deems it necessary, request 
evidence of authorization to sign. 
8. (1) The appointment of an attorney-at-Iaw shall be by an 
authorization of agent which shall be signed by the applicant or, if 
there are more than one, by each applicant. 
(2) The authorization of agent appointing an attorney-at-Iaw 
shall be filed together with the application and if the appointment is 
not thus made and is not in accordance with section 13 and subrule (1), 
any procedural steps taken by the attorney-at-law, other than the filing 
of the application, shall be deemed not to have been taken. 
9. (1) The application for the registration of a layout-design shall 
,be made on Form No, 1 and shall be signed by each applicant or 
attorney-at-Iaw. 
(2) The application shall indicate each applicant's name, 
address, nationality and residence. IP/N/IITTO/L/2 
Page 4 
(3) Where the applicant is the creator, the request shall contain 
a statement to that effect, and, where he is not, it shall indicate each 
creator's name and address and be accompanied by the statement 
justifying the applicant's right to the registration of the layout-design. 
(4) The brief and precise designation of the layout-design 
referred to in section 8(3)(a) shall consist of the title of the layout­
design indicating the matter to which it relates or indicating the field to 
which the article in which it is intended to be incorporated, or has been 
incorporated, relates. 
(5) Where the application was accompanied by a copy of the 
layout-design, the applicant shall file a drawing thereof within a period 
of one month. 
10. (1) The application may be withdrawn by written declaration Withdrawal 
submitted to the Controller and signed by each applicant. Or application 
(2) The applicatIOn fee shall not be refunded if the application 
is withdrawn. 
11. (1) Upon receipt, the Controller shall mark, on each document Marking 
making up the application, the actual date of receipt and the application 
application number consisting of the letters TT, slant, the letter t, 
slant, the numbers of the year in which the initial papers were received, 
slant, and a five-digit number allotted in the sequential order in which 
applications are" received and where any corrections or other later filed 
documents are received on different dates, the Controller shall also 
mark their actual date of receipt in the appropriate place of the request 
for registration of the layout-design (Form No. 1). 
(2) The application number allotted under paragraph (1) shall 
be quoted in all subsequent communications concerning the application. 
12. (1) The Controller shall examine whether the application According 
fu1fills the requirements set out in section 8(1) and (5). afinl.d nodtifteying 
llOg a ; 
Wh h C 11 fi d h h 1·· d·d examination· (2) ere t e ontro er m s t at t e app lcatIOn 1 not at ded!ion to • 
the time of receipt fulfill the requirements referred to in paragraph (1), grant or 
he shall invite the applicant to. file the required correction. refuse 
(3) The invitation to file any correction shall be in writing and 
it shall specify the correction or corrections required and request that 
these be filed within two months from the date of the invitation," 
together with the payment of the prescribed fee. 
(4) Once the Controller accords a filing date, he shall so notify 
the applicant in writing and if the application is treated as if it had not 
been filed, under section 8(8) or (10), the Controller shall notify the 
applicant in writing, stating the reasons. Registration; 
publication; 
issuance of 
certificate IPIN/lITTO/Ll2 
Page 5 
(5) Where the conditions set out in section 3(2) and (3) are not 
fulfilled, the Controller shall reject the application and notify the 
applicant in writing, stating the reasons. 
(6) Where the Controller finds that the conditions set out in 
section 8(2) and (3) and the Rules pertaining thereto are not fulfilled, 
he shall invite the applicant, in writing, to file the required correction 
within two months from the date of the invitation, together with the 
payment of the prescribed fee and if the applicant does not comply with 
the invitation to correct a deficiency, or where, despite corrections 
submitted by the applicant, the Controller is of the opinion that the 
said conditions are hot fulfilled, he shall reject the application and 
notify the applicant, in writing, stating the reaspns. 
(7) Refusal of the application shall not affect its filing date 
which shall remain valid. 
(8) The Controli~r shall notify the applicant, in writing, of his 
decision to grant or to refuse the application, and, in the case of a 
decision to grant the application, he shall request the applicant to pay 
the registration and pUblication fee within one month from the date of 
the notification. 
13. (1) Subject to the payment of the registration and publication 
fee within the period prescribed in rule 12(6), the Controller shall 
register the layout-design in accordance with section 9(2) and this rule, 
publish a reference to the registration and issue to the applicant a 
certificate of registration. 
(2) 'The Controller shall, allot to each layout-design he 
registers, a number in the sequential order of registration. 
(3) The registration of a layout-design shall incl\?-de, in 
addition to the particulars specified in section 9(3), a copy or drawing 
thereof, subject to section 8(3)(d), and shall specify-
(a) the name and address of the registered owner; 
(b) tpe name and address of the agent, if any; 
(c) the name and address of the creator, except where he has 
asked not to be named in the registration; and 
(d) the date of the first commercial exploitation, anywhere in 
the world, of the layout-design or an indication that such 
exploitation has not yet commenced. 
(4) The publication of the reference to the registration of a 
layout-design, under subrule (1), shall contain the particulars specified 
in subrule (3). 
(5) The certificate of registration of a layout-design shall be 
h;sued on Form No. 2. IP/NIIITTO/L/2 
Page 6 
14. (1) The Controller shall cause to be entered in the register in Entries in 
respect of every layout-design, in addition to the information indicated register 
in rule 13(3)-· . 
(a) the address for service; 
(b) the date on which the layout-design registration expired or 
was surrendered or cancelled; 
(c) any change in name or address, or any change in address 
for service Or ownership in accordance with rules 15 and 16; 
(d) the fact that a license contract has been concluded and 
recorded pursuant to section 11(3). 
15. (1) The request, under section 11, for the recording of a change Changes in 
in ownership of a layout-design registered under the Act or of an ownership 
application there for shall be made to the Controller on Form No. 3 and 
shall be subject to payment of the prescribed fee. 
(2) The publication of the change in ownership shall speCify­
(a) the number of the application or registration concerned; 
~ -. 
(b) the filing date, the date, if any, of first commercial 
exploitation, anywhere in the world, and· the date of 
registration; . 
(c) the owner and the new owner; and 
(d) the nature of the change in ownership. 
. (3) A license contract submitted for recordal under 
section 11(3) shall be accompanied by the prescribed fee. 
16. (1) There shall be furnished to the Controller- Address for 
. service 
(a) by every applicant for the registration of a layout-design, 
an address for service in Trinidad and Tobago for the 
purpose of his application; and 
(b) by' person, including the applicant for, or the owner of, a 
layout-design, as the case may be, concerned in any 
proceedings to which any of these Rules relate, an address 
for service in Trinidad and Tobago, 
and the address so furnished or, where another address being an 
address in Trinidad and Tobago, has been furnished in place thereof, 
that address shall be treated for the purposes of that application or 
those proceedings, as appropriate, as the address of that applicant or, 
as the case may be, of that person. 
(2) Where an attorney-at-law has been appointed in 
accordance with section 13 and Rule 8, the address of the attorney-at­
law shall, for all purposes cOl!nected with the Act and these Rules, be 
treated as the address to which communicatioI).S to the person who 
appointed the agent shall be transmitted. Excluded 
days IP/N/lITTO/L/2 
Page 7 
17. When the last day for doing any act or taking any proceeding 
falls on a day when the Controller's Office is not open to the public for 
business, it shall be lawful to do the act or to take the proceeding on the 
day when the Controller's Office is next open for business. 
Consultation 18. Consultation of the register shall be subject to payment of the 
;~~~s~~:; prescribed fee and requests for certified copies of extracts from. a 
extracts register or for copies of documents shall be made to the Controller in 
therefrom 't' d . h 11 b b' f h 'b d co and for copies wn mg an s a e su l)ect to payment 0 t e prescn e lee. 
of documents 
Inspection of 
licence 
contracts 19. The file relating to a license contract may be inspected and 
extracts obtained therefrom only with the written permission of the 
licensor and licensee. 
Correctionsof._. 20. (1) The Controller may correct any error of translation or 
errors transcription, clerical error or mistake in any application or document 
filed with the Intellectual Property Office. or in any matter recorded 
pursuant to the Act or these Rules. 
Hearing 
Service by 
mail (2) Corrections of errors may be made by the Controller upon 
receipt of a request in Writing and subject to such terms as he may 
consider appropriate, or on his own initiative. 
(3) Corrections made shall be communicated in writing to all 
interested persons, and, where considered necessary, shall be published 
by the Controller. 
21. (1) Before exercising adversely to any person any discretionary 
power given to the Controller by the Act or these Rules, the Controller 
shall notify such person, in writing, of the opportunity to be heard 
thereon, and indicating a time limit, which shall not be less than one 
month, for filing a request for a hearing. 
(2) The request for a hearing shall be in writing and shall be 
subject to payment of the prescribed fee. 
(3) Upon receiving such request, the Controller shall give the 
person applying, and any other interested persons, at least two weeks' 
notice, in writing, of the date and time of the hearing. 
22. Any notice, application or other document sent to the Controller 
by mail shall be deemed to have been given, made or filed at the time 
when it would be delivered in the ordinary course of the mail and in 
proving such sending, it shall be sufficient to prove that the letter 
containing such notice, application or other document·was properly 
addressed and sent by registered mail. IP/N/1/TTO/L/2 
Page 8 
23. The time or periods prescribed by these Rules for doing any act Extension of 
or taking any proceeding thereunder, may be extended by the time limit 
Controller if he thinks fit, upon such notice to the parties and upon 
·such terms as he may direct, and such extensions may be granted 
although the time or period for doing such act or taking such proceeding 
has already expired. 
24. At any stage of any proceedings before the Controller, he may Directions 8S 
d· h t h d t· fi t· ·d h . to furnishing lrect t a suc ocumen S, in orma lOn or eVl ence as e may requlre of documents 
be furnished within such period of time as he may fix. 
25. Any irregularity in procedure before the Controller may be Corrections of 
. d h h d· irregularities rectliie ,on suc terms as e may lrect. 
26. Where, under these Rules, any person is to do any act or thing, Dispensation 
or any document or evidence is required to be produced or filed, and it ~~ller 
is shown to the satisfaction of the Controller that from any reasonable 
cause that person is unable to do that act or thing, or that that 
document or evidence cannot be produced or filed, the Controller may, 
upon the production of such evidence and subject to such terms as he 
thinks fit, dispense with the doing of any such act or thing, or the 
production or filing of such document or evidence. 
27. The Controller's Office shall be open to the public from Monday Hours of 
to Friday inclusive, each week, between the hours of 9.00 a.m. and business 
3.00 p.m. for all classes of business. 
28. (1) Where under these Rules evidence may be filed, it shall be Evidence 
by statutory declaration or affidavit. 
(2) The Controller may, if he thinks fit, in any particular case, 
take oral evidence in lieu of or in addition to such evidence and shall 
allow any witness to be cross-examined on his affidavit or declaration. 
29. (1) Any statutory declaration or affidavit filed under the Act orststutory 
these Rules shall be made before any officer authorized by law in any decdl8rmatdion~ts an a 1 aVl 
part of Trinidad and Tobago to administer on oath for the purpose of 
any legal proceedings. 
(2) Statutory declarations or affidayit§ made outside Trinidad 
and Tobago shall be made before a consul or notary public. 
30. Particulars of layout-designs of integrated circuits and other Publication; 
proceedings under the Act and any other information required to be periodical 
published under the Act or these Rules shall be published monthly in a 
periodical unless the Controller otherwise directs. SCHEDUL:R T 
FEES 
Matter or Proceeding 
Application fee [Section 8(9)] 
Correction of application in order to comply 
with requirements for according filing date 
[Section 8(1} and (5); .Rule 12(2}] . 
Correction of application in order to comply with 
formal requirements [Section 8(2), (3) and (4); 
Rule 12(2}] 
Registration and publication fee [Section 9(2}; 
Rules 12(6} and 13(1)] 
Request for recordal of change in ownership 
[Section llU}; Rule 15(1)] 
Submission of licence contract for recordal [Section 
11(3); Rule 15(2)] 
Inspection of Register (for every quarter of an hour 
or part thereoO [Section 9(4); Rule 18») ... 
Certified copies of documents (per page) 
[Section 9(4); Rule 18)] 
Request for correction of error (Rule 20) 
Request for hearing [Section 17(1); Rule 21(2)] Amount of Fee 
$500.00 
$20.00 
$20.00 
$150.00 
plus 
fee for 
publicatiom 
$100.00 
$100.00 
$20.00 
$5.00 
per printer page 
and 
$20.00 
to certify 
correctness 
of documents 
$20.00 
$100.00 IP/NIlITTO/L/2 
Page 9 
(Rule 3) 
Form 
Form No. 1 
Form No. 3 IPINIlITTO/L/2 
Page 10 
SCHEDULE 1I 
[Rule 4 (1)] 
FORMS 
INTELLECTUAL PROPERITY OFFFICE, TRINIDAD AND TOBAGO 
Form No. 1 [Rule 9(1» 
LAYOUT-DESIGNS (TOPOGRAPHIES) OF 
INTEGRATED CIRCUITS ACT 
APPLICATION FOR REGISTRATION OF 
LAYOUT-DESIGN 
To: The Controller 
Intellectual Property Office For Official Use 
Date of Receipt by 
Intellectual Property Office: 
APPLICATION No.: 
(Office's Stamp) 
FILING DATE: 
Applicant's or Representative's 
File Reference: 
THE APPLICANT(S) REQUEST(S) THAT THE FOLLOWING LAYOUT-DESIGN 
BE REGISTERED: 
1. APPLICANT(S)· 
Additional information is contained in supplemental box D 
Name: 
Address: 
Nationality: 
Coun'try of residence or 
principal place of business: 
Tel. No. Telegraphic Address: Telex No.: Fax No.: 
-The data concerning each applicant must appear in this box or, if the space is 
insufficient, in the supplemental box. 
(Form No. 1, first page) Address for service in 
Trinidad and Tobago': 
H. ATTORNEY-AT-LAW SCHEDULE II-Continued 
The following (Attorney-at-law) has been appointed by the applicant(s) in the 
Authorization of Agent . 
D accompanying this Form 
Name: 
Address': 
Tel. No.: Telegraphic Address: Telex No.: Fax No.: 
Ill. REPRESENTATIONS OF THE LAYOUT-DESIGN 
This Form is accompanied by: 
four copies" of the layout-design; IP/N/1/TTO/L/2 
Page 11 
D 
D four copies" of the layout-design allowing the identification of the layout­
design, whereby such parts of the copies that relate to the manner of the 
manufacture of the integrated circuit have been omitted in accordance 
with section 8(3)(d); 
D 
o four drawings" of the layout-design; 
four drawings" of the layout-design allowing the identification of the 
layout-design, whereby such parts of the drawings which relate to the 
manner of manufacture of the integrated circuit have been omitted in 
accordance with section 8(3)(d). 
"Where an Attorney-at-law has been appointed, the address of the (Attorney-at-law) 
shall be treated as the address to which communications shall be transmitted 
[Rule 16(2)]. 
• 'Where the application is accompanied by a copy of the layout-design, a drawing 
thereof shall be filed within the period pre§cribed in Rule 9(5). 
(Form No. 1, second page) IP/N/1/TTO/L/2 
Page 12 
SCHEDULE II-Continued 
IV. DESIGNATION 
••••••••••••••••••••••••••••••••••••• o ••••••••••••••••••••••••••••••••••••••• o ••• ~ .............. ~ ••••••• o •••••••••••• o ........... . 
(Title of the layout-design indicating, pursuant to Rule 9(4), the matter to 
which it relates or the field to which the article in which it is intended to be 
incorporated, or has been incorporated, relates). 
V. CREATOR 
D The creator is the applicant 
If creator is not the applicant: 
Name: 
Address: Additional information is 
contained 
in supplemental box o 
The statement justifying the applicant's right accompanies this form D 
VI. COMMERCIAL EXPLOITATION 
D The layout-design has already been commercially exploited in ........................ . 
D Date of first commercial exploitation: 
The layout-design has not yet been commercially exploited, anywhere in the 
world 
(Form No. I, third page) SCHEDULE II-Continued 
VU. FEES accompany this Form 0 
VIII. SUPPLEMENTAL BOX' IPINIl/TTOILl2 
Page 13 
IX. SIGNATURE(S) .................................... [Applicant(s){Agent"] ................... . 
Date 
.................................... [Applicant(s)/Agent"] ................... . 
Date 
'Use this box if any of the boxes is not large enough ,to contain information to be 
furnished. Indicate the boxes continued in this box by their Roman numerals and title 
[(e.g., "11. APPLICANT(S) (continued)'1. 
"Type name(s) under signature and delete whichever does n'ot apply. 
TO BE FILLED IN BY THE CONTROLLER 
1. Date application received: 
2. Date of receipt of corrections and 
later filed papers completing the application: 
3. Date fees received: 
(Form No. I, fourth and last page) IP/N/IITTO/L/2 
Page 14 
SCHEDULE II-Continued 
INTELLECTUAL PROPERTY OFFICE, TRINIDAD AND TOBAGO 
Form No. 2 
LAYOUT-DESIGNS (TOPOGRAPHIES) OF INTEGRATED CIRCUITS ACT 
CERTIFICATE OF REGISTRATION OF 
LAYOUT-DESIGN 
In accordance with ~ection 9(2) and (3) and Rule 13, it is hereby certified that a 
layout-design having the registration No ..................................... has been registered for: 
Name: 
Address: 
on .................................................................................................................................. (date) 
in respect of a layout-de;ign disclosed in an application for registration of that layout­
design, having the following: 
filing date: 
date of first commercial exploitation: 
being a layout-design for: 
(title) 
created by: 
Name: 
Address: 
o A drawing of the layout-design accompanies this Certificate. 
Date ........................................................ . 
Controller 
(Form No. 2, only page) SCHEDULE lI-Continued 
INTELLECTUAL PROPERITY OFFFICE. TRINIDAD AND TOBAGO 
For Official Use 
Form No. 3 (Rule 15(1)J 
LAYOUT-DESIGNS (TOPOGRAPHIES) OF Received on: 
INTEGRATED CIRCUITS ACT 
RECORDlAL OF CHANGE IN OWNERSHIP 
To: The Controller 
Intellectual Property Office 
Applicant's or Representative's 
File Reference: 
1. IN THE MATTER OF: 
0 Application for Registration Filing Date: 
of Layout-Design No. IP/N/lITTO/L/2 
Page 15 
Date of first commercial exploitation: 
0 Layout-Design No.: Date of Registration: 
n. APPLICANT(S)/OWNER(S)* 
Name: 
Address: 
Ill. REQUEST 
The Controller is hereby requested to record the change in ownership of the 
above-ident.ified ..... ; ................................................................ • -
The present applicant(s)!owner(s)- is/are identified above. 
The new applicant(s)/new owner(s)· is/are identified below. 
·Delete whichever does not apply. 
··Indicate application or title concerned. 
(Form No. 3. first page) IP/N/1/TTO/L/2 
Page 16 
SCHEDULE II-Continued 
rv. NEW APPLICANT(S)/NEW OWNER(S)" 
Name: 
Address: 
Address for service in Trinidad and Tobago: 
Nationality: 
Country of residence or 
principal place of business: 
Tel. No.: Telegraphic Address: Telex No.: Fax No.: 
V. ADDITIONAL INFORMATION 
VI . o 
o o 
o The following items accompany this Form: 
The original or a certified copy of the document evidencing the change of 
ownership. signed by or on behalf of the contracting parties 
other documents evidencing the change in ownership (specify) 
fees 
other (specify) 
SIGNATURES 
.................................................. [New Applicant(s)/New Owner(s)/Agent**] ..................... . 
Date 
.................................................. [New Applicant(s)/New Owner(s)/Agent**] ..................... . 
Date 
[Applicant(s)/Owner(s)/Agent**) 
Date 
[Applicant(s)/Owner(s)/Agent*·) 
Date 
"Delete whichever does not apply. 
"*Delete whichever does not apply and type name(s} under signature. 
(Form No. 3. second and last page) 
Made this 2nd day of October, 1996. 
R. L. MAHARAJ 
Minister of Legal Affairs