Rule 11(1)

The technical questionnaire PVP-TQ
and the representations in Annex A
have to be submitted in duplicate
with this form. / Fee: SG$1600.00
Date of Receipt:
Number of extra sheets
attached to this form:

SINGAPORE

PLANT VARIETIES PROTECTION ACT 2004

PLANT VARIETIES PROTECTION RULES 2004

FORM PVP 3 / APPLICATION FOR GRANT OF PROTECTION
This form will take about 20-25 minutes to complete.
PART 1 / Your reference
PART2 / Particulars of applicant(s) for grant of protection
Name
Address
Country of incorporation/State of incorporation (if applicable)
Constitution

Sole Proprietor or Partners’ name(s)
PART3 / Botanical name

PART 4 / Common name
PART 5 / Proposed denomination
PART 6 / Brief description of plant variety

PART 7 / Representation of the plant variety
(If there are representations, please provide these at Annex A, with dimensions no larger than 15cm by 10cm.)
PART 8 / Have applications for plant variety protection been made in other countries?

Yes

No
Date of filing / Country / Application / Reference Number / Current Status / Denomination
PART 9 / Priority is claimed in respect of the earliest overseas application listed above:

Yes
No
PART 10 / Has the variety been sold or otherwise exploited within Singapore?

Yes
No
If yes, please indicate date of the first sale of the variety and the denomination used:
Date(dd/mm/yyyy) Denomination

PART 11 / Has the variety been sold or otherwise exploited outside Singapore?

Yes

No
Is the variety a tree or a vine?

Yes

No
Please indicate the date of first sale of the variety, the country where it was sold and the denomination used:
Date Country Denomination

PART 12 / If original breeder(s) is other than applicant(s) named in Part 2 above, please indicate whether the variety was transferred to theapplicant(s):

by assignment

by will
by other means
(please state details ) ______
PART 13 / Name and address of original breeder(s) as in Part 12 above:
PART 14 / Address for service
Name
Address

Telephone Fax

PART 15 / Declaration
I/We declare that I/we have been appointed by the person(s) named in Part 2 above to act as a/an procedural representative named in Part 14 above.
Signature ______
Date Month Year
Name ______
(in block letters)
Official capacity of signatory
Annex A / (Excluding the duplicate copy, the representations must not exceed more than 5.)

General Instructions

a. / The technical questionnaire PVP-TQ and the representations in Annex Amust be submitted in duplicate.Excluding the duplicate copy, the representations must not exceed more than 5.
b. / This form should preferably be typewritten to assist in processing.
c. / A separate form should be used for each application for protection or grant.
d. / This form when completed should be filed with the prescribed fee.
e. / If there is not enough space to fill in any part of this form, please use separate sheets.
f. / Please note that the address for service must be an address in Singapore. Your attention is drawn to rule 9 of the Plant Varieties Protection Rules 2004.
g. / Once you have filled in the form, please remember to sign and date it.
GST / GST INFORMATION
Tax Invoice*
Note:
Tax invoice will be issued to the entity/individual as indicated. Goods and Services Tax (GST)-registered businesses may claim input tax with Inland Revenue Authority of Singapore (IRAS), subject to meeting the requirements under the GST Act.
Name (Tax invoice to be issued to) / The name of the Applicant (as in PART 2 of this form) is to be indicated in this field.

V1.20170401Page 1 of 8