FORM 23
THE PATENTS ACT, 1970
(39 of 1970)
APPLICATION FOR REGISTRATION OF PATENT AGENT
[See rules 94 and 97]

I beg to apply for registration as a patent agent under the Patents Act, 1970
A certificate of character1 From……………………………………………………
...................................................................……………………is enclosed herewith.
I hereby declare that I am not subject to any of the disqualifications specified in rule 98 of the Patent Rules 1972 and that the information given below is true to the best of my knowledge and belief.
1. Name2………………………………………………………………………….
2. Address/place of residence......................................................……………..
3. Principal place of business :……………………………………………………….
4. Address of the branch office if any………………………………………………..
5. Father’s name :……………………………………………………………………
6. Nationality :……………………………………………………………………….
7. Date and place of birth.:…………………………………………………………..
8. Occupation :……………………………………………………………………..
9. Particulars of qualification for registration as patent agent 3………………………..
(a)………………………………………………………………………….
(b)………………………………………………………………………….
(c)………………………………………………………………………….
Dated this…………day of 19………/20…….
Signature4
(                 ) 5
1. Certificate testifying to the character of the applicant should be from a person not related to him and being a Gazetted Officer or any other Person whom the Controller thinks fit.
2. Family or principal name in the beginning.
3. Either original certificates and other documents or copies thereof duly attested by the Gazetted Officer or any other person whom the Controller thinks fit must be sent with the application.
4. To be signed by the applicant.
5. Name of the natural person who has signed.