FORM 12
THE PATENTS ACT, 1970
(39 of1970)
REQUEST FOR GRANT OF PATENT UNDER SECTION 52 (2)
[See rule 62]

I/We 1……………………………………………………………………
(a) 2…………………………………………………………………….
(b)3……………………………………………………………………..
(c)4……………………………………………………………………..
hereby declare:
(i) That I/we made a petition under section 64 of the Act before the High Court of 5………. and the details of the patent and the petition are given below.
Patent No.…dated……….Grantee/Patentee………Petition No.……. Dated………..
(ii) That I/we have claimed to be the true and first inventor (s)/assignee (s)/legal representative (s) of 6………………… the true and first inventor of the invention for which the said patent was granted.
(iii) That by an order in the said petition the patent was revoked/the complete specification of the patent was directed to be amended by exclusion of ………….claims thereof.
(iv) That the court ordered to grant to me a patent in lieu of the said patent/part of the invention excluded by the amendment.
(v) That I/we submit a statement and certified copy of the order of the Court in support of my application and request that a patent be granted to me in accordance with the order of the Court.
My/Our address for service India is: 7 ………………………………………………
Dated this………………….day of 19…………./20………………
Signature8
(                  )9
To
The Controller of Patents,
The Patent Office,
At…………………
Note:    (a) Strike out whichever is inapplicable.
(b) Fee: See the First Schedule.
1. Repeat the columns (a) to (c) if there are more than one applicant.
2.  Insert the name in full. Family or principal name in the beginning, if the applicant is a natural person,
3.  Insert the complete address including postal/or country.
4.  Nationality of the person.
5. Name of the High Court.
6. Name, address and nationality of the true and first inventor.
7.  Complete address including postal index number code state along with Telephone and telefacsimile number (s).
8. To be signed by the appliant (s) or authorised registered patent agent.
9. Name of the natural person who has signed .