FORM 10
THE PATENTS ACT, 1970
(39 of 1970)
APPLICATION FOR AMENDMENT OF PATENT
[See section 44 and rule 58]

I/We 1………………………………………………………..
(a) 2…………………………………………………………..
(b) 3……………………………………………………………..
(c) 4……………………………………………………………..
(a) 2………………………………………………………………
(b) 3……………………………………………………………..
(c) 4 ………………………………………………………….
Hereby request that Patent No…………………………dated…………………granted to……….. may be amended by substituting my/our name for the name of the grantee and in support to my/our request, I/We furnish the following documents:
……………………………………………………………………………………….
………………………………………………………………………………………
My/our address for service in India is:
5…………………………………………………………………………………………
…………………………………………………………………………………………
…………………………………………………………………………………………
Dated this ……………………..day of 19…………………./20…………………
Signature6
(               )6
To
The Controller of Patents,
The Patent Office
At……………….
Note:    Fee: See the First Schedule.
1. Repeat the Columns (a) to (c) if there are more than one applicant.
2. Insert the name in full. Family or principal name in the beginning if the applicant is a natural person.
3. Insert the complete address including postal index number/code and state and /or country.
 5. Complete address including postal index number/code and state along with Telephone and Telefacsimile number (s).
6. To be signed by the applicant (s) or authorised registered patent agent.
7. Name of the natural person who has signed.