FORM 22
THE PATENTS ACT, 1970
(39 of 1970)
PERMISSION TO WORK THE PATENTED INVENTION
[See section 88(4) and rule 84]

I/We 1…………………………………………………………………………..
hereby apply for permission to work the invention of Patent No……………………
dated…………granted to………..for which the patentee is………………………
(i) The Patent has been endorsed with the words “Licences of Right” under section 86,
OR
The Patent is deemed to be endorsed with the words “Licences of Rights” under Section 87.
(ii) I/We have made a requisition to the patentee under sub-section (1) of Section
88.
OR
I/We have applied to the Controller to settle the terms on……………………………..
(iii) The reasons for making the application are as follows:
..........................................................................................................................
I/We request that I/we may be permitted to work the invention under such terms as the Controller may think to impose.
My/Our address for service in India is:
2...............................................................................................................................….
………………………………………………………………………………………..
Dated this……….day of 19………/20……
Signature3
(                     ) 4
To
The Controller of Patents,
The Patent Office,
At……………………..
Note:      (a) Fee: See the First Schedule.
  (b) Strike out whichever is inapplicable.
1. Name, address and nationality of the applicant(s).
2. Complete address including postal index number/code and state along with Telephone and Telefacsimile number(s).
3. To be signed by the applicant(s) or authorised registered patent agent.
4. Name of the natural person who has signed.