Form 3

(Section 12(4)(b)(i) and 13(3)(a)(i))

Translation form

1. Your Reference :
2. Local application or registration number:
3. Foreign application or registration number or publication number of applicaton: :
4. Applicant's or Proprietor's Name *:
Address *:
Telephone Number:
Email Address *:
TRN *:
5. What kind of translated document listed at note C are you sending with this form?
6. Date of the foreign grant or amendment (day/month/year):
7. Address:
Email Address:
Country:
8. Do you want the address for service recorded on the Register to replace the address for service currently on the Register?
10. Contact's Name *:
Contact's Address:
Contact's Telephone Number:
Contact's Email Address:
Date (day/month/year):
Application Fee $:
Notes
A. This form shall be used when filing - (i) a translation into English under section 12(3)(b); or (ii) a translation into Englsih under section 13(3)(a).