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Declaration-Plant Patent Application
DECLARATION-PLANT PATENT APPLICATION
State of [State]
County of [County]
My name, address, citizenship, and residence are as follows:
Full name of inventor: [Full Name of inventor]
Citizenship: [Citizenship]
Residence: [Residence]
Post Office Address: [Post Office Address]
I believe that I am the original inventor of the new and distinct variety of [Name of or a Description of the Plant] which I have described and claimed in the foregoing specification. I have asexually reproduced this new and distinct variety. To the best of my knowledge and belief, this variety was never known or used in the United States prior to my invention of it. Nor was this variety ever patented or offered for sale in the United States prior to my invention of it. I also recognize that I have a duty to disclose material information pertaining to this application of which I am aware.
To the best of my knowledge and belief, all the statements made herein are true and were made with the knowledge that willful false statements are unlawful and are punishable by fine or imprisonment, or both.
Signature Date