ブータン王国知的財産権出願許可依頼申請

Application for seeking prior approval for applying for intellectual Property Right

1. Full particulars of the applicant
a) Name:
b) Address:
c) Professional profile:
d) Organizational affiliation (Please attach relevant documents of authentication)

2. Details of the invention on which IPRs are 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 were 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 responsible for any incorrect/ wrong information.
Signature………………………………
Name……………………………………
Title………………………………………

Community Biodiversity Traditional Knowledge Documentation

1. Prior Informed Consent at Individual/Community Level
The ……… (name of the Community/individual) agrees to document traditional knowledge associated with biological/biochemical resources. Understanding that this will help in reducing the erosion of knowledge, and will preserve and protect the knowledge of the ….(community/individual) and the nation as a whole to be passed on to our future generations, we herein consent the Authorized Agency to document the TK in accordance with the procedure provided in the Rules.

Dzongkhag:………………………………………….
Geog:……………………………………………….
Village……………………………………………..
Village Representative Signature (tshokpa):………………………………………….
Name of the Tshokpa……………………………………….
Authorized Government Agency Representative Signature……………………………………
Name of the Authorized Agency representative……………………………………………………………
Seal of the government office applying for the consent letter
Date ……………………………………

←戻る