FORM 6

THE PATENT ACT, 1970

(39 of 1970)

&

THE PATENTS RULES, 2003

CLAIM OR REQUEST REGARDING ANY CHANGE IN
APPLICANT FOR PATENT

[See section 20(1),20(4),20(5); rule 34(1),35(1),36(1)]

I/We

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Sr	Name	Address	Nationality	E-Mail	Phone

hereby request that the application for patent No {{applicationNumber}} dated {{applicationDate}} made by

{{originalApplicantRows}}

Sr	Name	Address	Nationality	E-Mail	Phone

may proceed in my/our name and further request that direction of the Controller, if necessary be made in that effect.

Reasons for making the above request are as follows:-
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Furnished the following documents:
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My/our address for service in India is:
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Signature

This Form is electronically Signed.