no “THE GAZETTE OF INDIA : EXTRAORDINARY Pari
FORM 27
THE PATENTS ACT, 1970
No Fee (39 of 1970)
&
‘The Patents Rules, 2003
Statement regarding the working of the patented
invention on commercial scale in India
[See section 146(2) and rufe 134(1) J
1. Insert name, {mn the matter of Patent No..
address and awe
nationality. ~
2. State the year to ‘The patentee (s) oF licensee {s) under Patent
which the Nonsense hereby furnish the following
statement relates statement regarding the working of the
patented invention referred to above on @
commercial scale in India for the
3. Give whatever
details are {0) The patented invention:
ovanabie, 4, ead Retwoted ere evant
| (a) if not worked: reasons for aot working and stops being
taken for working ofthe inveion
(worked: quantum and value (@n Rupees), of the
patented produc:
i) manufactured mn nee
i) ported rom athe counties. (Give
country wise detals)
(i) the licenses and subvicanses aranied during te yeer:
{i state whetner pubic requirement has been ret
partyfadequatayto the fullest exert at reasonable price.
‘The facts and matters stated above are true to the
best of mylour knowledge, information and belief.
Dated this a GY OF scscsesenee eee 200 verses
4, To be signed by
person(s) giving Signature’ ..
the staternent,
To
The Controter of Patents
‘The Patent Office
at
a
‘Note: (a) Strike out whichever is not applicable.”
Eee