Filling in form DF12A

Section 1

This is optional, but we will use it in correspondence if included.

Section 2

We will need either the design application, or registered number(s) to process this form.

Section 3

Is the application in your name or your company's name? If you apply in your company's name, tell us where it is incorporated, including the state if it is in the United States of America.

If you have applied to us before you will have been given an ADP (Automatic Data Processing) number. This is our reference number for you. Please include your ADP number, if you know it.

Section 4

This field should be completed only if you are recording a change of ownership. We will need the full name and address of the new owner.

Section 5

This field should only be completed if you are recording or cancelling a licence or security. Please state what it is you are recording or cancelling.

Section 6

Please state the full name and address of the licensee or the grantee of the security interest.

All Cases

Section 7

If you have completed box 4 or box 6 please state if the new owner is a corporate body and state which country it is incorporated in. If in America, say which state it is incorporated in.

Section 8

Please state the exact day, month and year on which the transfer of ownership (assignment), licence or security agreement took place.

Section 9

It will help us to solve any queries more quickly if you can provide the name, address and daytime telephone number of someone that we can contact.

Section 10

This section should be signed by, or on behalf of the person(s)/company making the application. Documentary evidence sufficient to establish the assignment, transmission, or operation of law should accompany this form if the form cannot be signed in this section by, or on behalf of the other parties names in section 4 and 5.

In the case of a mortgage or the grant of a license, it is not also signed by or on behalf of the mortgagor or grantor of the license (if not the person named in section 5).

Date

This means the date the form is filed.

Section 11

The name and daytime telephone number of the person to contact in case of a query