Geographical Indications of Goods (Registration & Protection) Act, 1999

Geographical Indications of Goods (Registration & Protection) Rules, 2002

Form GI 3A

Application for the Registration of an Authorized User [Section 17 (1), Rule 56 (1)]

Fee: Rs. 10 [ See entry No.3A of the First Schedule]

(1) Name of the Applicant (proposed Authorized user ): ___________________________

(2) Address of the applicant __________________________________________________

(3) Address of service (if different from Above) : __________________________________

(4) Registered Geographical Indication for which application is made: _________________

(5) Email id: ________________________________________________________________

(6) Phone/mobile number :________________________________________

Declaration:

(1) I hereby declare that I have enclosed the statement of case and evidence of due service of copy of my application to the registered proprietor (Name of registered proprietor) for____________, registered as a Geographical Indication.

(2) I also declare that all the above information is true and correct to the best of my knowledge and belief.

(3) I undertake that if any of the information is found incorrect or false, my application may be rejected and if already accepted, my registration maybe revoked and my name removed from Part B of the register.

Date:

Place: SIGNATURE

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