application form national ip awards 2014
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1
Annexure-1
Application for National IP Awards 2014
(Patents, Designs and Trademarks)
Category of Applicant (please “”)
Institutions Industry Individual
Academic
Institution
R & D
Institution
in
healthcare
Indian Public Limited
Company / Private
Limited Company /
Firm / Society / Indian
subsidiary of a
transnational
corporation
MSME
Category of IP for which application is made (please “”)
Patent Trademark Design
Mention the sector (chemical, mechanical, drugs, food, electrical, computer hardware,
computer software, biotechnology, or any other):
_________________________________________________________________________
Applicant Details
Name of Organization
Postal address
Website
Name of the contact person
Designation of the contact person
Telephone no. (landline and
mobile) of contact person
Email id:
What is the value of IPR (patents / trademarks / designs) shown in your balance sheets of the
last five years, if applicable? Please also indicate the value as a percentage of the fixed assets.
Combined value of all IPRs may also be given.
2012-13 2011-12 2010-11 2009-10 2008-09
Value of IPRs (Rs.)
Percentage of fixed
assets
2
Do you have an IP Department or IPR Policy in place? Do you have a system of auditing
your IP assets from time to time? A brief write up is needed. (Enclose the copy of IP policy,
if any)
Do you have any system for finding out if your IPRs are being infringed and taking steps to
protect the same? A success story may be provided.
Do you have a policy of licensing-in IPRs from other sources? If yes, please provide a short
write up.
3
How have the IPRs owned by you contributed towards the betterment of humanity and/or
socio-economic development of the country?
Certified that the information submitted herein is true to the best of my knowledge and belief.
(Signatures)
(Name & designation of the
Applicant /Authorised signatory)
NOTE: The applicants are required to provide a proof of their eligibility with respect to the
category under which they have applied e.g. certificate of registration etc.
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Annexure-1A
Application for National IP Awards 2014 (Geographical Indications of Indian Origin)
1. Applicant Details
Name of organization
Postal address
Website
Name of the contact person
Designation of the contact person
Telephone no. (landline and
mobile) of contact person
Email id:
Nature and structure of the
organization. Details should be
provided.
2. Name of the Geographical Indication, date of filing (dd/mm/yyyy) and date of registration
(dd/mm/yyyy):
________________________________________________________________________
3. Mention the Goods (Natural / agricultural / manufactured / industrial / handicraft / textile /
food stuff / wines / spirits or any other) :
________________________________________________________________________
4. Provide the details regarding annual sales turnover of the Geographical Indication in
accordance with your audited balance sheets. Data pertaining to the period three years prior
to the registration (so far as applicable) till 31st March 2013 should be provided.
Year Annual Turnover (Rs.) Number of goods sold
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5. Please provide details of exports and foreign exchange earned, if any, in accordance with
your audited balance sheets. Data pertaining to the period three years prior to the
registration (so far as applicable) till 31st March 2013 should be provided.
Year Annual Turnover (please mention
the foreign exchange)
Number of goods sold
6. Provide details of quality control measures being followed, details of structure and working
of the inspection body as well as the internal watch dog mechanism, and the details of
inspection(s) conducted by the inspection body as well the internal watch dog mechanism.
7. Please provide details of any litigation with regard to ownership of the geographical
indication.
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8. Whether any action regarding infringement of the geographical indication has been taken?
Do you have any system for finding out if your geographical indication is being infringed
and whether you are taking steps against the infringer? A success story may be provided.
9. What are the steps taken for promotion of the geographical indication? Please provide a
short write up.
10. What steps have been taken to register the producers as authorized users? Please provide a
short write up.
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11. Details of geographical indication authorized user application(s) filed / registered?
i. Number of GI Authorised User Applications filed:______________
ii. Number of GI Authorised Users registered: ___________________
12. Being the registered proprietor, how have you contributed towards the betterment of socio-
economic development of the producers? What steps have been taken for the purpose of
creating awareness among producers?
13. Whether any recognition / award has been received from a National or International Agency
relating to geographical indications, after the registration? Details may be provided, along
with copy of the same.
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14. Did you ever participate in a state, national or international level exhibition or fair, after the
registration?
15. Write a brief note on the impact of registration of the geographical indication?
Certified that the information submitted herein is true to the best of my knowledge and belief.
(Signatures)
(Name & designation of the
Applicant /Authorised signatory)
NOTE: The applicants are required to provide documentary proof in support of their
information / claim. e.g. certificate of registration, audited balance sheet, copy of the GI
certificate etc.
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Annexure-2
Application for Patent Award
A. Number of Patent Applications filed, granted and in market (in India) in the last 5 years
2012-13 2011-12 2010-11 2009-10 2008-09
First filed in India
Filed through
National Phase /
Convention route
Granted (where applications
were first filed in India)
Granted (where applications
entered India through
National Phase /
Convention route)
Number of patents
commercialised
in India
Note: Copies of the patent certificates of registration are required to be submitted, along with this
Annexure, of all the granted patents being claimed by the Applicant for the purpose of this para.
B. Number of PCT/Convention Applications filed in Foreign Countries, granted and
commercialized outside India in the last 5 years (names of countries should be specified)
2012-13 2011-12 2010-11 2009-10 2008-09
Filed
Granted
Countries in which
granted
Number of patents
commercialised
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C. Details of Patents licensed out to third party in the last five years?
i. Number of patents licensed
ii. Details of patents licensed
S.No. Patent No. Licensed to Manner of commercialization
D. Number of new products / processes launched during the last five years based on patents
granted to you.
2012-13 2011-12 2010-11 2009-10 2008-09
E. Do you have any collaborative R&D arrangements with Indian companies / foreign
companies? Please indicate the number of such collaborations undertaken in the last 5 years
along with the names of collaborators.
F. Do you have on-going research programs with any university or research laboratory in
India? If yes, provide a list of such programs.
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G. Year-wise R&D budget in India in the last five years. Please also give the number of R & D
Scientists.
2012-13 2011-12 2010-11 2009-10 2008-09
R & D Expenditure
in India (Rs.)
R & D Expenditure
in India as percentage
of total expenditure
in India
Number of R & D
Scientists in India
Certified that the information submitted herein is true to the best of my knowledge and belief.
(Signatures)
(Name & designation of the
Applicant /Authorised signatory)
12
Annexure-3
Application for Trademark Award
A) Number of trademarks filed & registered (in India) in the last 5 years
2012-13 2011-12 2010-11 2009-10 2008-09
Filed
Registered
In the market
Note: Registration numbers of all the registered marks should be submitted by the Applicant, along
with this Annexure, for the purpose of this para.
B) Number of trademark applications filed and registered outside India in the last 5 years
2012-13 2011-12 2010-11 2009-10 2008-09
Filed
Registered
Countries in which
registered
No. of trademarks
in the market
C) Details of trademarks licensed out in the last five years?
i. Number of trademarks licensed out
ii. Details of trademarks licensed
S.No. Trademark No. Licensed to
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D) Number of new products / services launched during the last five years based on your
registered marks.
2012-13 2011-12 2010-11 2009-10 2008-09
Certified that the information submitted herein is true to the best of my knowledge and belief.
(Signatures)
(Name & designation of the
Applicant /Authorised signatory)
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Annexure-4
Application for Design Award
Number of designs filed & registered (in India) in the last 5 years
2012-13 2011-12 2010-11 2009-10 2008-09
Filed
Registered
Commercialised in
India
Note: A copy of the certificate of registration is required to be submitted, along with this Annexure, of
all the registered designs being claimed by the Applicant for the purpose of this para.
Number of Design applications filed & granted outside India in the last 5 years (names of
countries should be specified)
2012-13 2011-12 2010-11 2009-10 2008-09
Filed
Registered
Countries in which
registered
In the market
C. Details of Design you have licensed out to any third party in the last five years?
i. Number of Designs licensed out
ii. Number of Designs in the market
(among the licensed out designs)
iii. Details of designs licensed out
S.No. Registered design
number
Licensed to
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D. Number of new articles launched during the last five years based on Designs registered.
2012-13 2011-12 2010-11 2009-10 2008-09
Certified that the information submitted herein is true to the best of my knowledge and belief.
(Signatures)
(Name & designation of the
Applicant /Authorised signatory)