The Designs Rules,2001
Form 12.
FORM 12Fee** APPLICATION FOR ENTRY OF A MORTGAGE ORLICENCE IN REGISTER OF DESIGNSSection 30 1Insert (in full) name, address and nationality. I (or we)1 ________________________________________ ________________________________________________ hereby apply that you will enter in the Register of Designs a notice of the following interest. 2Insert the nature of the
claim, whether by way of mortgage or licence. I (or we) claim to be entitled2 ____________________ _________________________________________________ to an interest. 3Specify the particulars of such document giving its date, and the parties to
the same, and showing how the claim here made is
substantiated. _________________________________________________ in the Registered Design(s) No.(s)* ____________________ Class ___________ by virtue of3_______________________ _________________________________________________ And in proof whereof I (or we) transmit the accompanying4__________________ with an attested copy thereof. 4Insert the nature of the document. My (or Our) address for service in India is :- _______________________________________________ Dated this ______________ day of ____________ 2000
5To be signed by the applicant or authorised agent.
(Signed)5 _______________________________________TO
THE CONTROLLER OF DESIGNS,
THE PATENT OFFICE, CALCUTTA.
________________________________________________________
NOTE: * If the appliaction is in respect of more than one design, the numbers thereof as well as the other particulars required may be given in a separate schedule which should be attached to this Form.
** In respect of one Design Rs. 500.00
For each additional Design Rs. 200.00