インド知的財産権出願許可申請FORM III

Application for seeking prior approval of National Biodiversity Authority for applying for Intellectual Property Right

1. Full particulars of the applicant
　i. Name
　ii. Address:
　iii. Professional profile
　iv. Organizational affiliation (Please attach relevant documents of authentication):

2. Details of the invention on which IPRs sought

3. Details of the Biological resources and /or associated knowledge used in the invention.

4. Geo-graphical location from where the biological resources used in the invention are collected

5. Details of any traditional knowledge used in the invention and any identified individual /community / holding the traditional knowledge

6. Details of institution where Research and Development activities carried out.

7. Details of economic, biotechnological, scientific or any other benefits that are intended, or may accrue to the applicant due commercialization of the invention.

Declaration

I/we declare the Information provided in the application form is true and correct and I /We shall be responsible for any incorrect / wrong information.

Signed

Place

Name

Date

Title

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