2 “THE GAZETTE OF INDIA: EXTRAORDINARY Peer See. 3) FORM 1 ‘THE PATENTS ACT 1970 (FOR OFFICE USE ONLY) (39 of 1970) & Application Ne ‘The Patents Rules, 2003 Filing Date: APPLICATION FOR GRANT OF PATENT _| Amount of Fee Paid: (Bee section 7,548 135and rule20 {1)) CBR No: __ Signature _ 4, APPLICANT (8) a Nationality Aatress ___ [Nationality - ‘Address ‘STILE OF THE INVENTION _— _ ‘4 ADDRESS FOR CORRESPONDENCE OF Telephone No. APPLICANTIAUTHORIZED PATENT AGENT IN INDIA | Fax No, Mobile No. _ E-mail __ | 5. PRIORITY PARTICULARS OF THE APPLICATION (S) FILED IN CONVENTION COUNTRY ‘Country ‘Application | Filing Date Name of the | Title of the | Number ( Applicant | vention | [ _ | I 8. PARTICULARS FOR FILING PATENT COOPERATION TREATY (PGT) NATIONAL PHASE APPLICATION a _ | [Yaternational application num ‘ternational fling date as allotted by the receiving | otf, it PARTICULARS FOR FILING DIVISIONAL APPLICATION ‘Original (irs) application number. Date of fling of Original (first) application LC &. PARTICULARS FOR FILING PATENT OF ADDITION [ Main application/patent Number. Dae of fing of main application a5 ‘9. DECLARATIONS: — ‘( Dectaration by the inventor(e) We, the above named inventor(s) is/are the true & first Inventor(s) for this invention and dectare that the applicant(s)herein is/are my/our assignee or legal representative. (a) Date, (b) Signature(s) (c) Name(s) a (li) Declaration by the applicant(s) in the convention country We, the applicant(s) in the convention country declare that the applicant(s}herein is/are my/our assignee or legal representative. (a) Date, | (b) Signatures) (Name(s) of the signatory ee[enor 36) SOHN: ETT 8 (ili) Declaration by the applicant(s) | Wie the applicants) hereby declares) that: lam MWe are in possession of the above-mentioned invention 5 The provisionalcompete specication relating tothe invenion is fled wth this application. 10 The invention as disclosed in the specication uses the biological material from India and the necessary permission from the competent authority shall be submitted by me/us before the grant of patent to me/us. There is no lawful ground of objection to the grant of the Patent to melus. | am/ We are the assignee or legal representative of true & first inventors. ‘The application or each of the applications, particulars of which are given in Para - 5 was the first application in convention country/countries in respect of my/our invention, (© We claim the priority from the above mentioned application(s) filed in convention country/cauntries and state that no application for protection in respect of the invention Kad been made in a convention country before that date by meus or by any person from which We deriva the title. 2 Mylour application in India is based on international application under Patent Cooperation Treaty (PCT) as mentioned in Pata - 6. © The application is divided out of myfour application particulars of which are given in Para - 7 and pray that this application may be treated as deemed to have been filed on under sec. 16 of the Act. © The said vention is an improvement in or modification of the invention particulars of which are given in Para - 8, 10. Following are the attachments with the application: (a) Provisional specification/Complete specification (b) Complete specication (in conformation withthe international applicationYas amended before the Intemational Preliminary Examination Authority (IPEA), as applicable (2 copies). No. of pages __No. of claims (©) Drawingé (in conformation with the international applicationjias amended before the International Preliminary Examination Authority (IPEA), as applicable (2 coples),No. of sheets, (A) Priority documents {(@) Translation of priority document/Specificatiow/international Search Report (8, Statement and undertaking on Form 3 (g) Power of Authority (h) Decteration of inventorship on Form 5 ti) Sequence Voting In etecronic foe { poo =i Gath? Choque / Bank Oat basing na Se ——C—e==eT—‘éa‘=CUUDCCN herein are correct and We request tha! 2 pan may be grand to meus for Ye eed vention Dated this... 8Y Ole nen Signature Name | To, The Contre of Patent | tne Patent Offer, at | Nate: "Repeat boxes In case of more than one entry. “To be signed by the applicant(s) or by authorized registered patent agent otherwis | stick (Weross (=) whichever is appicableinot applicable in declaration in para-8. ‘Name of the inventor and applicant should be given ia full, family name inthe bogiening. “Complete address of the inventor and applicant thouk! be glvan stating the petal Index nolcode, state and country. *Strike out the column which is/are not applicable * For fee: See First Schedule _| where mentioned.