FORM 3

THE PATENTS ACT, 1970

(39 of 1970)
&
THE PATENTS RULES, 2003
STATEMENT AND UNDERTAKING UNDER SECTION 8
(See section 8, rule 12)

We, VERTELLUS SPECIALTIES INC. of 201 North Illinois Street, Suite 1800
Indianapolis, Indiana 46204, United States of America, hereby declare that
we who have made this Application No. ……………..…… dated ………………………..
alone, made for the same/substantially same invention application(s) for patent in the
other countries, the particulars of which are given below:

Name of Date of Application Status of Date of Date of

Country Application. No the Publication Grant
Application
The 1 June 61/654,153 Lapsed _ _
United 2012
States of
America
Patent 31 May PCT/US2013/043703 Published 5 December _
Cooperation 2013 2013
Treaty
that the rights in the application(s) has/have been assigned to none;
that we undertake that up to the date of grant of the patent, by the Controller, we
would keep him informed in writing the details regarding corresponding applications
for patents filed outside India within six months from the date of filing of such
application.
Dated this 11 December 2014

Signature:

Name: MALATHI LAKSHMIKUMARAN

IN/PA-1433
OF LAKSHMI KUMARAN & SRIDHARAN
AGENT FOR THE APPLICANT(S)

To,
The Controller of Patents
The Patent Office at New Delhi

PD014859IN-NP