FORM 17
THE PATENTS ACT, 1970
(39 of 1970)
APPLICATION FOR REGISTRATION OF TITLE / INTEREST IN A PATENT OR SHARE IN IT OR REGISTRATION OF ANY DOCUMENT PURPORTING TO AFFECT
PROPRIETORSHIP OF THE PATENT
[See section 69(l), 69(2) and rules 74(l), 74(2) and 74(3)]

I/We1........................................................................................................................
……………………………………………………………………………………….
……………………………………………………………………………………….
Hereby apply that my/our name(s) may be registered in the register of patent as a person entitled to the patent/a share in the patent/an interest in the patent details of which are specified below:
Patent No dated grantee patentee and in proof thereof we transmit the accompanying 2………….with a certified copy thereof.
OR
Transmit herewith an attested Copy of 2……………………………………………in
Respect of Patent No.(s). ………. Dated…………….granted to……..……….of which
The patentee is………………………………………as well as the original document for
Verification and I/We hereby apply that a notification thereof may be entered in the register of patents.
My/Our address for service in India is:
3......................................................................................................................................
...................................................………………………………………………………
Dated this……………day of 19………… /20………..
Signature4
(              ) 5
To
The Controller of Patents,
The Patent Office,
At………………………
Note:   (a) Fee: See the First Schedule.
(b) Strike out whichever is inapplicable.
1. Insert name, address and nationality of the applicant(s).
2. A description of the nature of the document, giving the date and the names, address and nationality of the parties thereto.
3. Complete address including postal code and state along with Telephone and Telefacsimile number(s).
4. To be signed by the applicant or authorised registered patent agent.
5. Name of the natural person who has signed.