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S. Details Required Please write the details


1. Applicant Name G Y Pathan

(Write the name of Company or Firm or

Individual, in whose name the trademark to be
2. Address of the Applicant C-1116 SiddhiVinayak Towers Makarba

Ahmedabad: 380051 (Gujarat) INDIA

3. Type of Organisation Individual

(Write whether Pvt. Ltd./Public Ltd./LLP/
Partnership Firm/ Proprietorship Firm/ Trust/
4. Whether Small Business or Large Enterprise N.A.
(Not applicable to Individual Applicants)
Large Enterprise means
in Plant & Machinery is more than Rs. 10 crore
For SERVICE INDUSTRY: If investment in office
equipment is more than Rs. 5 crore
5. Full name of all the Partners/Directors N.A.
(Applicable only In case of Pvt. Ltd./Public
Ltd./LLP/ Partnership Firm)
6. Full name of the person who will sign Pathan Gulammohiyuddin Yusufkhan
Authorization Letter
(i.e. on behalf of company/LLP/firm/trust)

7. Residence address, Age, Nationality, Bungalow No.26 Samir Vihar Soc., Bh.Agro
Mobile No. & Email Id of the Signatory
Petrol Pump, Hotel Stand, Sarkhej Road,

Ahmedabad: 380055 (Gujarat) INDIA

8. Mark/Brand Name

9. Logo/Image Explanation: Explain in 2- 3 lines The Logo of “Title Clearance” contains

the image or style or figure or design of logo
1) Brand Name “Title Clearance”
(Required if the brand name consists a logo)
2) Logo of a House with Chimney on it

Eg: “The trademark consist of the alphabet with Cross Leaf design upwards
‘S’ with sharp ends pointing towards upward
direction applied over the background of circle” towards Chimney

10. Trade description of Goods/Services Legal Services throughout the Country with
(Please write exact goods or services sold / promoted
under this brand name, in 3-4 lines. Include only Network of
specific goods or services name)
Eg: Software Development: Software development Lawyers/Advocates/Attorneys/Solicitors
and IT enabled services.
11. Write whether the applicant is N.A.
Manufacturer /Trader/ Service Provider
12. User Date of the Brand/Mark Since the Year 2012
(Please write the approx date since when brand
is in use. if currently not in use give the approx
date from when it will be in use)
13. Service Address C-1116 SiddhiVinayak Towers Makarba
(Please write the address where you want the
Trademark registry to communicate with you) Ahmedabad: 380051 (Gujarat) INDIA

14. GSTIN Number of the Applicant NA

(This is require to prepare the TAX Receipt after
completion of the process OR mentioned NA (if
not applicable or you don't have it)