FORM-5

THE PATENT ACT 1970

(39 of 1970)
&
The Patent Rules, 2003
DECLARATION AS TO INVENTORSHIP
(See section 10(6) and rule 13(6)]

1.NAME OF THE APPLICANT(S) Dr Pranay Wal

Dr Kuldeep Singh
Navneet Kumar Verma
Dr. Asheesh Kumar Singh
Dr Dev Prakash
Mr Prashant Singh
Mr Ankur Srivastava
Mr Virendra Kumar Maurya

Hereby declared that the true and first inventor(s) of the invention disclosed in the complete
specification filled in pursuance of my/own application numbered dated is/are

2.INVENTOR (S)

Dr Pranay Wal, Professor & Dean Pharmacy, Pranveer Singh Institute of Technology
(Pharmacy), NH-2 Bhauti Road, Kanpur, UP

Dr Kuldeep Singh, Associate Professor, Faculty of Pharmacy, Integral University, Dasauli,

Basha, Kursi Road, Lucknow, UP

Navneet Kumar Verma, Assistant Professor, Department of Pharmaceutics, Buddha Institute of

Pharmacy GIDA Gorakhpur UP.

Dr. Asheesh Kumar Singh, Director, Buddha Institute of Pharmacy GIDA Gorakhpur UP.

Dr Dev Prakash, Principal-cum-Director, HIMT College of pharmacy, Greater Noida. UP

Mr Prashant Singh, Assistant Professor, Department of Pharmaceutics, Buddha Institute of

Pharmacy, GIDA Gorakhpur UP.

Mr Ankur Srivastava, Assistant Professor, Department of Pharmaceutics,Rameshwaram

Institute of Technology and Management, Lucknow UP

Mr Virendra Kumar Maurya, Assistant Professor, SmtFulehra Smarak College of Pharmacy,

Ballia, UP
rd
Dated this 3 day of February 2022

Dr Pranay Wal
Dr Kuldeep Singh
Navneet Kumar Verma
Dr. Asheesh Kumar Singh
Dr Dev Prakash

Signature Not Verified

Digitally Signed.
Name: PRANAY WAL
Date: 04-Feb-2022 19:15:52
Reason: Reason - Testing
Location: DELHI
Mr Prashant Singh
Mr Ankur Srivastava
Mr Virendra Kumar Maurya

Signature:-
Name of the Applicant:-
Dr Pranay Wal
Dr Kuldeep Singh
Navneet Kumar Verma
Dr. Asheesh Kumar Singh
Dr Dev Prakash
Mr Prashant Singh
Mr Ankur Srivastava
Mr Virendra Kumar Maurya

4.STATEMENT (to be signed by the additional inventor (s) not mentioned in the application form ) I/We
assent to the invention referred to in the above declaration, being included in the complete specification
filled in pursuance of the stated application

Dated this..........................day of......................20.........................

Signature of the additional inventor (s):-

Name of the signatory:-

To, The controller of patent

The patent office, at New Delhi