Patents Form 27

―FORM 27 
THE PATENTS ACT, 1970 
(39 of 1970) 
AND 
THE PATENTS RULES, 2003 

No Fee 

STATEMENT REGARDING THE WORKING OF PATENTED INVENTION(S) ON A COMMERCIAL 
SCALE IN INDIA 

1. Insert name, address, 
nationality, patent 
number(s). 

2. State the financial year to 
which the statement relates. 

3.   Worked / not worked. 
Please state whether each 
patent in respect of which 
this form is being filed is 
worked or not worked. 

4. If worked. 

[See section 146(2) and rule 131(1)] 

I/ We, the Patentee(s)/ Licensee ______, in respect of patent number(s)  _____, 
furnish this statement, 
(Explanation: One form may be filed in respect of multiple patents, provided all of them 
are related patents, wherein the approximate revenue / value accrued from a particular 
patented  invention  cannot  be  derived  separately  from  the  approximate  revenue/value 
accrued from related patents, and all such patents are granted to the same patentee(s)). 
in respect of the financial year ____ 

Patent Number(s) 

Worked [Tick () if 
applicable] 

Not worked [ Tick () if 
applicable] 

 (a)  Approximate  revenue  /  value  accrued  in  India  to  the  patentee(s)/  licensee 
furnishing the statement from patent number(s) where the working is through: 
 (1) Manufacturing in India   .. (in 
INR) 

 (2)  Importing into India _____ (in INR) 

(b) Brief in respect of (a) above (maximum 500 words) 

5. If not worked. 

Reasons for not working the patented invention(s) and steps being taken for working of 
the invention(s).(maximum 500 words) 

6. To be signed by 
Patentee(s) / 
Licensee / Authorised 
Agent furnishing the 
statement. 

The facts and matters stated above are true to the best of my/ our knowledge, 
information and belief. 
Dated this _________ day of  _____________ 20_______ 
Signature(s) _________________________________ 

To 
The Controller of Patents, 
The Patent Office, 
at _______ 

Note:  Every  patentee  and  every  licensee  (exclusive  or  otherwise)  is  required  to  file  this  Form;  where  a  patent  is 
granted to two or  more persons, all such patentees  may  file this Form jointly; however, each licensee shall file this 
Form individually. ”.