1. The applicant hereby requests the International Bureau to indicate the availability for licensing purposes of the invention(s)
claimed in this international application on the PATENTSCOPE website.
2. Licensing terms (optional): The applicant is willing to license the claimed invention(s):
in:
all PCT Contracting States
all PCT Contracting States except (indicate each State by its two-letter code): ______________________________
______________________________________________________________________________________________
the following State(s) only (indicate each State by its two-letter code): ____________________________________
______________________________________________________________________________________________
for exclusive use by the licensee for non-exclusive use by the licensee
3. Additional licensing terms (optional) (if the space below is insufficient, please use the Annex to this form):
4. Licensing contact:
Any person interested in a licensing agreement for the invention(s) claimed in this international application should contact the
following person:
5. Signature of applicant(s), agent or common representative:
Form PCT/IB/382 (January 2012)
PATENT COOPERATION TREATY
REQUEST FOR INDICATION OF AVAILABILITY FOR LICENSING PURPOSES
PCT
Priority date
(day/month/year)
International filing date
(day/month/year)
Applicant’s or agent’s file reference
International application No.
Applicant
Name: Capacity: Date:
Form PCT/IB/382 (Annex) (January 2012)
Continuation of item 3 (If this Annex is not used, this sheet should not be included in this request):
International application No.
ANNEX TO FORM PCT/IB/382
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