Form I

First Schedule

THE PROTECTION OF GEOGRAPHICAL INDICATIONS REGULATIONS ACT

The Protection of Geographical Indicator Regulations, 2009

Application for registration of geographical indication

(Pursuant to Regulation 9)

Application is hereby masge for registration of the geographical indication (details of

which accompany this Form) in the name of the Applicant(s) acting in the capacity of:

The particulars required for the purposes of the application are set out below:

PARTICULARS

I. APPLICANTS

Applicant's Name :
Address
Mailing Adress(if any)
Nationality
Telephone Number:
Email Address (if any):
Fax Number:
Address for Service in Jamaica:

II. DULY AUTHORIZED AGENT:

The following has been appointed by the applicant as his duly authorized agent

Agent's Name :
Agent's Address
Agent's Telephone Number:
Agent's Email Address (if any):
Agent's Fax Number:

III. GEOGRAPHICAL INDICATION

The geographical indication for which registration is sought is the following:

Indications:

IV. GEOGRAPHICAL AREA

The following is the demarcation of the territory of the country, region or locality in that territory to which the geographical indication application applies, and from which the goods for which the geographical

indication is used originate:

Representation of Douments, Maps, Forms and Graphic:

V. Goods

The goods for which the geographical indication is used are the following:

Enter Goods:
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VI. QUALITY, REPUTATION OR OTHER CHARACTERISTICS

The quality, reputation or other characteristics of the goods for which the geographical indication is used, and any conditions under which then indication may be used, are the following:

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Charge for Service: $