FORM 17
THE PATENTS ACT, 1970 (39 of 1970)
&
The Patents Rules, 2003
APPLICATION FOR COMPULSORY LICENCE
[See section 84 (1), 91, 92(1) or 92A; rule 96]
- Name, address, and nationality of the applicant(s).
- Certified copies of the documents are to be enclosed in duplicate.
- A complete address including postal code and state along with telephone and fax number(s).
- To be signed by the applicant(s) or his authorized registered patent agent.
- Name of the natural person who has signed.
I/We,1 ………………………………………………... ……………………………………………………….. hereby apply for the grant of a compulsory license under Patent No. …………… dated ………….. granted to ………………….. for which the patentee is ………………… on the following grounds namely: -…………………………………………………………………………………………………………
I /We declare that the facts and matters stated herein are true to the best of my/our knowledge, information and belief.
The details of documentary evidence in support of my/our interest and the grounds stated above are given below2 …………………..
- …………………………………………
- …………………………………………
- …………………………………………
My /Our address for service in India is3 ……..…… ……………………………………………………
Dated this ……………… day of ….…………. 20…...
Signature4
(……………………………………)5
To
The Controller of Patents,
The Patent Office,
At………………………….
Note: - For fee: See the First Schedule.
