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Environmental Information System Centre(ENVIS)

Technology Transfer

NATIONAL ENVIRONMENTAL ENGINEERING RESEARCH INSTITUTE (NEERI)
BUSINESS DEVELOPMENT UNIT

Application Form for Technology Transfer from NEERI

Name of the Technology applied for

Name of the party/legal entity with contact details

Name of the applicant, nationality& contact details

Details of Registration as an industry/legal entity (copy of certificate to be enclosed)

Address of works & Registered office premises

State full names and full addresses of persons having direct financial interest (applicable for proprietary and partnership firm)

Details of the manufacturing experience, qualifications and experience of party and partners, if any, with details of the technical expertise available to show that the party can handle technical aspects of production, quality control and marketing (Use separate sheets)

Financial background with latest copy of audited annual report attached

Name and address of the Bankers

Production capacity plan & space available for the proposed production work

Marketing plan and estimated market potential

Any other information to substantiate technical and financial competence of the party

Details of past interaction / association with NEERI/CSIR or any Indian Organization

(Separate sheets may be enclosed if the space provided is insufficient. Application with incorrect and incomplete information will not be considered)

I/We request that I/We may be considered for granting technical know-how for the production of . I/We assure that all the information provided by me/us on this form is true to best of my/our knowledge, and on the basis of this information any decision taken by NEERI shall be accepted by me/us. I / We also undertake to furnish any further information required in this connection.

Date:

Place:

Signature

Name & Office seal :

Note:

1.Technology Transfer fee will be charged separately to the selected party accepting the    technology.Technology transfer fee/royalty shall be
drawn in favor of "Director,    NEERI, Nagpur" and must be sent to Scientist & Head, Business Development Unit,    NEERI,
Nagpur-440020, India.
2.Please note that this is only an application processing fee and does not confer any rights    for Technology Transfer.
3.Foreign applicants may please note that their application will be considered subject to    clearance from statutory bodies.

Address to

   Mr. P.S. Dutt
   Scientist & Head
   Business Development Unit
   NEERI, Nagpur-440 020
   India

   Tel: +91-712-2249758
   Fax: +91-712-2249758
   Email: ps_dutt@neeri.res.in

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