FORM-18

THE PATENTS ACT, 1970

(39 of 1970)

&

The Patents Rules, 2003

REQUEST FOR EXAMINATION OF APPLICATION FOR PATENT

[see section 11B; rule 24B(1)(i) ]

Name :  {{applicantName}}

Nationality:  {{applicantNationality}}

Address:  {{applicantAddress}}

We hereby request that the application for Patent No. {{applicationNumber}} filed on {{filingDate}} for the invention titled '{{inventionTitle}}' shall be examined under Sections 12 and 13 of the Act.

Address for Service shall be

{{serviceAddress}}

Phone No. {{phoneNumber}}     E-mail: {{emailAddress}}

Dated this {{form18DateFormatted}}

{{signatureImage}}

{{signatureName}}

On behalf of the Applicant

To

The Controller of Patents, Chennai

The Patent Office, Chennai