NATIONAL RESEARCH DEVELOPMENT CORPORATION

20-22, Zamroodpur Community Centre, Kailash Colony Extension, NEW DELHI 110 048 Phone: 11-29240401-08; Fax: 11-29240409-10; E-mail: write2@nrdc.in Regional Office: 107, 8th Main, Malleswaram, BENGALURU 560 055 Phone: 80-23341255; Fax: 80-23347555; E-mail: nrdc@vsnl.com; nrdcro@gmail.com Website: http://www.nrdcindia.com

[An Enterprise of Department of Scientific & Industrial Research, Ministry of Science & Technology, Government of India]

NATIO NAL PATE NT PR O TE CTIO N SCH E ME APPL ICATIO N FO RM FO R FINANCIAL ASSISTANCE FO R PATE NTING IN IND IA i) P le a se r e a d the instr u c tions a t the e nd of this d oc u me nt be f or e f illing ii) To be fille d a nd su bmitte d in THR EE se ts 1. Titl e of Invention: 2. Pa r ti cul a r s of Inventor (s ) in CAPITAL S: Sl # Na me (w ith initia l ex pa n d ed ) 1. 2. 3. 4. 5. Q u a l ifica tion D es ign a tion

3. Cor r es ponding Inventor s Na me a n d Ad d r es s : (ple a se note tha t the sole r e sponsibility of c or r e spond e nc e be twe e n NRDC / P a te nt O f f ic e / Attor ne y will be on the c or r e spond ing Inve ntor ) Inventor (s ) Pos ta l Addr es s Tel ephone: Mobil e: Fa x : E - ma il : In ven tor (s ) Al ter n a tive Ad d r es s (r es i) Tel ep h on e: Mob il e: Fa x : E - ma il :

4. O r ga nis a tion Na me a nd Addr es s : (Pl ea s e n ote th a t in in s titu tion a l a p p l ica tion for Res ea r cher s in Univ. /R& D Ins tt. / L a b etc th e or ga n is a tion w ou l d b e a p p l ica n t a n d th is mus t be a l ega l entity, kindl y confir m fr om H ea d of th e O r ga n is a tion . ) 1. O r ga nis a tion Na me a nd Addr es s Tel ephone: Fa x : E - ma il : 2. O r ga n is a tion Na me a n d Ad d r es s (if a n y) Tel ep h on e: Fa x : E - ma il :

5. Sta tus of D evel opment: 6. Tes t conducted if a ny, if yes deta il s of r es u l t: 7. Sta tus of Pa tent: (if a pplic a tion a lr e a d y file d , Applic a tion No. with Da te , P le a se e nc lose a c opy of P a te nt Applic a tion/ (P r ovisiona l/ C omple te S pe c if ic a tions) a s f ile d ) 8. H a ve you conducted Pa tent Sea r ch? Ye s / No (if y e s, a tta c h the pa te nt se a r c h r e por t)

9. Br ief a bs tr a ct of invention (In a bou t 500 wor d s) :

10. E x is ting s ta te - of- the - a r t: (Give fu ll d e ta ils, inc lu d e se a r c h r e por ts)

11. D r a w ba cks in ex is ting s ta te - of- the - a r t & h ow th e d r a w b a cks h a ve b een over come b y you r invention:

12. O bj ectives of the invention:

13. Novel fea tur es of the invention:

14. Adva nta ges over other kno w n a l ter n a tives Na tion a l a n d G l ob a l :

15. D eta il ed des cr iption of the invention (The d e ta ile d d e sc r iption shou ld be a c c ompa nie d with d ia gr a ms, d r a wings with P r ope r L e ge nd s a nd mu st be r e la te d to the d e sc r iption):

16. De ta ils of pr oc e s sing fe e :

Dr a f t No.

Da te :

Ba nk:

Amou nt:

17. U nd e r ta king a nd S igna tu r e of a ll the Inve ntor (s) with d a te : Un d er ta kin g In pu r su a nc e to the r u le s a nd r e gu la tions of Na tiona l P a te nt P r ote c tion S c he me of NR DC , I/ We he r e by d e c la r e a nd u nd e r ta ke tha t: The a bove infor ma tion is tr u e to the be st of my / ou r knowle d ge a nd be lie f . I/ We ha ve / ha ve not se c u r e d a ny F ina nc ia l Assista nc e f r om a ny institu tion or f u nd ing a ge nc y f or the d e ve lopme nt. If the infor ma tion pr ovid e d in the a pplic a tion or la te r on d u r ing pr ose c u tion of pa te nt a pplic a tion is f ou nd to be inc or r e c t or the a pplic a tion is a ba nd one d by not pr ovid ing c la r if ic a tions to the q u e r ie s r a ise d a t a ny sta ge be for e the gr a nt of the pa te nt, NR DC ha s the r ight to r e c ove r a ll the e xpe nd itu r e inc u r r e d on this a ppl ic a tion. I/ We will pa y pa te nt a nnu ity , whic h be c ome s d u e a t the time of gr a nt a nd su bse q u e ntly ma inta in it a t my / ou r own c ost. I/ We ha ve gone thr ou gh the r u le s a nd r e gu la tions of the S c he me a nd will a bid e by the m. I/ We he r e by fu r the r u nd e r ta ke to ind e mnif y NR DC a ga inst a ny c la im f or br e a c h of inte lle c tu a l pr ope r ty r ights of thir d pa r ty by my / ou r pa te nta ble te c hnology or the pr od u c t d e ve lope d u nd e r the pa te nta ble te c hnology . Sl # 1. 2. 3. 4. 5. Na me with initia l(s) e xpa nd e d S igna tu r e with d a te

Certificate by Employer/Institute
This is to c e r tify tha t the inve ntion is the wor k of the Inve ntor s a nd is r e c omme nd e d for filing P a te nt in Ind ia by NR DC . This inve ntion is/ is not a n a ssignme nt of e mploy me nt.

Da te : P la c e :

S igna tu r e of the He a d of O r ga nisa tion Seal

the title of invention list all the names as given in the application form along with affiliation

16. Enc losu r e s: P le a se c he c k be for e se nd ing the a pplic a tion f or m whe the r y ou ha ve e nc lose d the f ollowing in TH RE E SE TS : a) De ta ile d d e sc r iption b) Re pr ints/ c u ttings of pu blic a tion of y ou r inve ntion, if pu blishe d c) P a te nt spe c ific a tion (P r ovisiona l/ C omple te ) d) Dr a wings/ Dia gr a ms with pr ope r le ge nd s/ title e) A De ma nd Dr a ft for ` 500.00 (P r oc e ssing f e e ) F or mor e inf or ma tion ple a se c onta c t: S r Ma na ge r & He a d (IP R ) Intel l ectua l Pr oper ty Con s u l ta n cy & Ma n a gemen t D ivis ion

Shri Govind Sharma

NATIONAL RESEARCH DEVELOPMENT CORPORATION

20-22, Zamroodpur Community Centre, Kailash Colony Extension, NEW DELHI 110 048 Phone: 11-29240401-08 Extn 216; Fax: 11-29240409-10; Mob: 09910496549 E-mail: gsharma@nrdc.in

[An Enterprise of Department of Scientific & Industrial Research, Ministry of Science & Technology, Government of India]

INSTRUCTIONS FOR FILLING-UP OF APPLICATION FORM

1. TITLE OF INVENTION: Invention title should be brief, concise, appropriate, and reflective of the invention and should be within 120 characters, kindly avoid fancy names. 2. PARTICULARS OF INVENTOR (S): Full name in CAPITAL LETTERS with initial expanded, and addresses of all individuals responsible for the development should be indicated in the form. QUALIFICATIONS: Fill in the appropriate code for your highest qualification as per table given below: Subjects Diploma Bachelor Master M Phil Ph D Subjects Diploma Bachelor Master M Phil Ph D Sciences DO1 BO1 MO1 LO1 PO1 Medicine DO5 BO5 MO5 LO5 PO5 Social Sciences DO2 BO2 MO2 LO2 PO2 Pharmacy DO6 BO6 MO6 LO6 PO6 Agriculture DO3 BO3 MO3 LO3 PO3 Technology DO7 BO7 MO7 LO7 PO7 Management DO4 BO4 MO4 LO4 PO4 Others DO8 BO8 MO8 LO8 PO8 3. ADDRESS OF INVENTOR (S) & APPLICANT (S): Address, telephone number, fax number and e -mail ID of the First Applicant / Group Leader should be filled and that of the remaining applicants should be given on separate sheets in the same format. Any change in address should be intimated immediately, so that, correspondence from NRDC is correctly addressed. Please note that in institutional application of Researchers in University/R&D Institute/ Laboratory etc the organisation would be applicant and this must be a legal entity, kindly confirm from Head of the Organisation. 4. ADDRESS OF APPLICANT (S): Address, telephone number, fax number and e -mail ID of the Head of The Organisation should be filled. Any change in address should be intimated immediately, so that, correspondence from NRDC is correctly addressed. In case of Institutional application of Researchers in University/R&D Institute/ Laboratory etc the organisation would be applicant and this must be a legal entity, kindly confirm from Head of the Organisation. 5. STATUS OF DEVELOPMENT: Choose the appropriate code for the status of development. See the Process or Product category according to your invention. (a) PROCESS (b) PRODUCT Stage of Development Stage of Development Lab Scale LS Static Model SM Pilot Scale PS Prototype PR Semi Commercialized SC Working Model WM Commercialized CO Commercialized CM Commercially Proven CP Commercially Proven PN 6. TEST STATUS: Refer to the table below for appropriate code: SL. # Test Status SL. # Test Status 1 Self Tested ST 4 Tested by Private Agency TP 2 Not Tested NT 5 Tested by Industry TI 3 Tested by Govt. Agency TG Full details of the tests and quantitative data o btained during test should be provided. 7. STATUS OF PATENT: If you have already filed a patent application, then write the Application No. with Date of filing, Please also enclose a copy of Patent Application/ (Provisional/ Complete Specifications) as it was filed. 8. DETAILS OF PATENT SEARCH: If conducted an international Patent Search then please provide details of keywords of the technology searched, date conducted and Period Covered, kindly attach the patent search report. 9. BRIEF ABSTRACT OF THE INVENTION: Under brief description the applicant should give the abstract of the invention highlighting all the major essential features of the invention in not more than 500 words. 10. EXISTING STATE-OF-ART: List the details of the processes, how the work is/ was being performed before the invention was carried out by the inventor. 11. DRAWBACKS IN THE EXISTING STATE-OF-ART: Indicate the drawbacks in the existing state -of-art, which prompted the Inventor for the Invention. 12. OBJECTIVES OF THE INVENTION: List the main objectives to be attained by the invention. 13. NOVEL FEATURES OF THE INVENTION: List the novel features of the invention which overcome the drawbacks of the existing state of art. The claim of Novelty should be substantiated by pin pointing in de tail the relevant aspects. 14. ADVANTAGES OVER ALL OTHER KNOWN ALTERNATIVES: Indicate the advantages in terms of reductions in capital cost, operating cost for the same performance. Improved reliability, performance, productivity, robustness, safety, layou t, service ability, range of applications, utility, directly or as an attachment may be labeled under the advantages. 15. DETAILED DESCRIPTION: The detailed description should be as exhaustive as possible, it should give the specifications, performance characteristics, limitation, principle of design/construction, details of method of construction / process / manufacture etc. It should be supported by relevant drawing, diagrams and circuit details, as required. It should be typed on one side of A4 size pape r leaving left and right margins and should not exceed ten pages

(the title of invention)

16. The application must accompany a demand draft of ` 500/- in favour of National Research Development Corporation payable at New Delhi only as a fee for processing the application. For more details please visit http://www.nrdcindia.com/guidelines.htm http://www.nrdcindia.com/rulespatassistance.htm http://nrdcindia.com/patform.htm