FORM 19
THE PATENTS ACT, 1970
(39 of 1970)
&
The Patent Rules, 2003
APPLICATION FOR REVOCATION OF A PATENT FOR NON-WORKING
[See section 85(1); rule 96]
- Name, address, and nationality of the applicant(s).
- State the nature of the applicant’s interest, the facts on which he relies and the grounds on which the application is made.
- Certified copies of all the documents are to be enclosed in duplicate.
- A complete address including postal index number/code and state along with telephone and fax number(s).
- To be signed by the applicant(s) or by his authorized registered patent.
- Name of the natural person who has signed.
I/We1 .......................................................................... ...................................................................................... hereby apply for revocation of Patent No. ………………... dated ……………. granted to …………………… for which the patentee/applicant for a patent is ………………………………… for the following reason, namely:2 ………………………………………………………
The details of documentary evidence in support of my/our interests and reasons stated above are given below:3 ………………….
- ……………………………………………….
- ………………………………………………
- ………………………………………………
I /We declare that the facts and matters stated herein are true to the best of my/our knowledge, information and belief.
My/Our address for service in India is4 ………………………………………………………………………………………………………………
Dated this ……………. day of ……………20……
Signature,5
(………………………….)
To
The Controller of Patents,
The Patent Office
At …………………………….
Note: - (a) For fee: See the First Schedule.
(b) Strikeout whichever is not applicable
