“FORM 1 (FOR OFFICE USE ONLY)

THE PATENTS ACT 1970 (39 of 1970) and

THE PATENTS RULES, 2003
APPLICATION FOR GRANT OF PATENT
(See section 7, 54 and 135 and sub-rule (1) of rule 20)
Application No.
Filing date:
Amount of Fee
paid:
CBR No:
Signature:
1. APPLICANT’S REFERENCE /
IDENTIFICATION NO. (AS ALLOTTED BY
OFFICE)
2. TYPE OF APPLICATION [Please tick ( ) at the appropriate category]
Ordinary () Convention ( ) PCT-NP ( )
Divisional Patent of Divisional Patent of Divisional Patent of Addition ( )
() Addition ( ) () Addition ( ) ()
3A. APPLICANT(S)
Name in Full Nationality Country of Address of the Applicant
Residence
House No. ECE Dept
1. MUKILAN S INDIAN INDIA
Street Bannari Amman Institute
2. DHANISH KUMAR V INDIAN INDIA
of Technology
3. PRAVEEN S INDIAN INDIA
City Sathyamangalam
4. LOGESHWAREN V INDIAN INDIA
State TamilNadu
5. DHAYANANTH R
INDIAN INDIA
Country India
6. Dr. SARAVANA KUMAR R
INDIAN INDIA
7. Mr. RAMKUMAR R Pin code 638401
INDIAN INDIA
3B. CATEGORY OF APPLICANT [Please tick ( ) at the appropriate category]
Natural Person () Other than Natural Person
Small Entity ( ) Startup () Others ( )

4. INVENTOR(S) [Please tick ( ) at the appropriate category]

Are all the inventor(s) Yes ( ) No ()

same as the applicant(s)
named above?
If “No”, furnish the details of the inventor(s)

5. TITLE OF THE INVENTION

ANTI-COLLISION SYSTEM IN HAIRPIN BENDS

6. AUTHORISED REGISTERED PATENT IN/PA No.

AGENT(S)
Name
Mobile No.
7. ADDRESS FOR SERVICE OF APPLICANT IN Name MUKILAN S
INDIA Postal Address Bannari Amman Institute of
Technology
Telephone No. 04295226176
Mobile No. 6379210449
Fax No. 042595226666
E-mail ID [email protected]
 8. IN CASE OF APPLICATION CLAIMING PRIORITY OF APPLICATION FILED IN CONVENTION
COUNTRY, PARTICULARS OF CONVENTION APPLICATION
Country Application Filing date Name of the Title of the IPC (as classified in the
Number applicant invention convention country)

9. IN CASE OF PCT NATIONAL PHASE APPLICATION, PARTICULARS OF

INTERNATIONAL APPLICATION FILED UNDER PATENT CO-OPERATION TREATY (PCT)
International application number International filing date

10. IN CASE OF DIVISIONAL APPLICATION FILED UNDER SECTION 16, PARTICULARS OF

ORIGINAL (FIRST) APPLICATION
Original (first) application No. Date of filing of original (first) application

11. IN CASE OF PATENT OF ADDITION FILED UNDER SECTION 54, PARTICULARS OF MAIN
APPLICATION OR PATENT
Main application/patent No. Date of filing of main application
12. DECLARATIONS
(i) Declaration by the inventor(s)
In case the applicant is an assigneed: the inventor(s) may sign herein below or the applicant
may upload the assignment or enclose the assignment with this application for patent or
send the assignment by post/electronic transmission duly authenticated within the
prescribed period).
I/We, the above named inventor(s) is/are the true & first inventor(s) for this Invention and
declare that the applicant(s) herein is/are my/our assignee or legal representative.
(a) Date
(b) Signature(s)
(c) Name(s)1. Mukilan S 2. Dhanish Kumar V 3. Praveen S 4. Logeshwaren V 5 .Dhayananth R
(ii) Declaration by the applicant(s) in the convention country
(In case the applicant in India is different than the applicant in the convention country: the
applicant in the convention country may sign herein below or applicant in India may
upload the assignment from the applicant in the convention country or enclose the said
assignment with this application for patent or send the assignment by post/electronic
transmission duly authenticated within the prescribed period)

I/We, the applicant(s) in the convention country declare that the applicant(s) herein is/are
my/our assignee or legal representative.
(a) Date
(b) Signature(s)
(c) Name(s) of the signatory

(iii) Declaration by the applicant(s)

I/We the applicant(s) hereby declare(s) that: -
  I am/ We are in possession of the above-mentioned invention.
  The provisional/complete specification relating to the invention is filed with this
application.
  The invention as disclosed in the specification uses the biological material from India
and the necessary permission from the competent authority shall be submitted by
me/us before the grant of patent to me/us.
  There is no lawful ground of objection(s) to the grant of the Patent to me/us.
  I am/we are the true & first inventor(s).
  I am/we are the assignee or legal representative of true & first inventor(s).
  The application or each of the applications, particulars of which are given in
Paragraph-8, was the first application in convention country/countries in respect of
my/our invention(s).
  I/We claim the priority from the above mentioned application(s) filed in convention
country/countries and state that no application for protection in respect of the
invention had been made in a convention country before that date by me/us or by
any person from which I/We derive the title.
  My/our application in India is based on international application under Patent
Cooperation Treaty (PCT) as mentioned in Paragraph-9.
  The application is divided out of my /our application particulars of which is given in
Paragraph-10 and pray that this application may be treated as deemed to have been
filed on DD/MM/YYYY under section 16 of the Act.
  The said invention is an improvement in or modification of the invention particulars
of which are given in Paragraph-11.
 13. FOLLOWING ARE THE ATTACHMENTS WITH THE APPLICATION
(a) Form 2
Item Details Fee Remarks
Complete/ No. of pages : 8
provisional
specification)#
No. of Claim(s) No. of claims : 4
No. of pages :1
Abstract No. of pages :1
No. of Drawing(s) No. of drawings and : 2
No. of pages : 2

# In case of a complete specification, if the applicant desires to adopt the drawings filed with his
provisional specification as the drawings or part of the drawings for the complete specification
under rule 13(4), the number of such pages filed with the provisional specification are
required to be mentioned here.
(b) Complete specification (in conformation with the international application)/as amended
before the International Preliminary Examination Authority (IPEA), as applicable (2 copies).
(c) Sequence listing in electronic form
(d) Drawings (in conformation with the international application)/as amended before the
International Preliminary Examination Authority (IPEA), as applicable (2 copies).
(e) Priority document(s) or a request to retrieve the priority document(s) from DAS (Digital Access
Service) if the applicant had already requested the office of first filing to make the priority
document(s) available to DAS.
(f) Translation of priority document/Specification/International Search Report/International
Preliminary Report on Patentability.
(g) Statement and Undertaking on Form 3
(h) Declaration of Inventorship on Form 5 (i)
Power of Authority

(j)…………………………………………………………………………………………………..
Total fee ₹ 4500 in Cash/ Banker's Cheque /Bank Draft bearing No __________
Date__________ on Bank.
I/We hereby declare that to the best of my/our knowledge, information and belief the fact
and matters slated herein are correct and I/We request that a patent may be granted to
me/us for the said invention.
Dated this 13 day of July 2021
Signature:

Name: 1. Mukilan S 2. Dhanish Kumar V 3. Praveen S 4. Logeshwaren V

5. Dhayananth R

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