Scribd Logo
Upload

Welcome to Scribd!

  • Patent App Form

    Uploaded by

    Heidi Newton
    20 views1 page
    Biswajit Banerjee, an Indian male born on April 18, 1983, has applied to take the patent agent examination in 2010. He has a Master's degree in Computer Application and provides his present and permanent addresses, contact information, and a list of enclosed documents including proof of age, degree certificate, character certificate, photographs, and specimen signatures. He declares that the information provided is true and correct.

    Original Description:

    Copyright

    © Attribution Non-Commercial (BY-NC)

    Available Formats

    DOCX, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Report this Document
    Biswajit Banerjee, an Indian male born on April 18, 1983, has applied to take the patent agent examination in 2010. He has a Master's degree in Computer Application and provides his present and permanent addresses, contact information, and a list of enclosed documents including proof of age, degree certificate, character certificate, photographs, and specimen signatures. He declares that the information provided is true and correct.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    20 views1 page

    Patent App Form

    Uploaded by

    Heidi Newton
    Biswajit Banerjee, an Indian male born on April 18, 1983, has applied to take the patent agent examination in 2010. He has a Master's degree in Computer Application and provides his present and permanent addresses, contact information, and a list of enclosed documents including proof of age, degree certificate, character certificate, photographs, and specimen signatures. He declares that the information provided is true and correct.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 1

    APPLICATION FORM FOR PATENT AGENT EXAMINATION, 2010

    1. FULL NAME OF THE APPLICANT : BISWAJIT BANERJEE.


    (In Block letters)
    2. GENDER : MALE.
    3. DATE OF BIRTH (DD/MM/YYYY) : 18/04/1983
    4. NATIONALITY : INDIAN.
    5. NAME OF FATHER/HUSBAND : BIJON KUMAR BANERJEE.
    6. EDUCATIONAL QUALIFICATIONS : Master in Computer Application.
    (Degree level) : PG
    7. PASSPORT NO. (if any) : G5226931.
    8. APPLICATION FEE DETAILS
    9. DD No. 555196 DATE 03-12-2009 ISSUING BANK ORIENTAL BANK OF
    COMMERCE.
    10. CHOICE OF EXAMINATION CENTRE
    (PLEASE TICK) : MUMBAI/KOLKATA/CHENNAI/DELHI

    11. PRESENT ADDRESS : C/O Indronil Chatterjee, 160-H,


    Pocket A2, Mayur Vihar Phase – III,
    New Delhi – 110096.

    12. PERMANENT ADDRESS : C/O Bijon Kumar Banerjee,


    “Balika Bhaban”, Radha Nagar Road,
    Nimtala, Punjabi Para,
    P.O. Radha Nagar, Burnpur,
    Dist. Burdwan, West Bengal,
    Pin – 713325, Ph No.: 03412259472.

    13. CONTACT NUMBER : 09953957105


    14. EMAIL ADDRESS : banerjeebiswajit83@gmail.com
    15. LIST OF ENCLOSURES (please tick) :
    i. Attested copy of proof of age.
    ii. Attested copy of degree certificate.
    iii. Character Certificate in original.
    iv. Two copies of self attested passport size photographs.
    v. Two specimen signatures on A4 size Paper.
    I HEREBY DECLARE THAT THE INFORMATION AS GIVEN ABOVE IS TRUE AND
    CORRECT TO THE BEST OF MY KNOWLEDGE AND BELIEF.

    PLACE : New Delhi.


    SIGNATURE.

    DATE : 10-12-2009.

    You might also like