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PATENT INFORMATION DECLARATION (This Declaration contains a Release)
To: The Husqvarna AB and corporate entities thereof, including
Insert the relevant group company name that you think would be interested in evaluating your idea
(herein after all collectively referred to as “Husqvarna”) In accordance with the terms and conditions set out below, I hereby submit for evaluation by Husqvarna an idea relating to: and described in Patent No. or Published Application No.:
(herein after referred to as the “Idea”). Unless a formal, written contract is subsequently entered into, I acknowledge and agree that no obligation of any kind is assumed by, nor may be implied against Husqvarna in connection with the submission of the Idea, and that the only obligations assumed shall be those expressly stated in such contract. For the avoidance of doubt, I do not by this submission grant to Husqvarna any rights to the Idea and Husqvarna shall not be under any obligation to compensate me for any disclosure of the Idea. I acknowledge and agree that no relationship of trust or confidence exists, nor is such relationship created or implied between Husqvarna and the undersigned in connection with the submission of the Idea. Unless otherwise explicitly agreed in writing, these terms shall apply to all of my disclosures to Husqvarna relating to the Idea. In consideration of Husqvarna evaluating my Idea, I, for myself or my corporate entity, as applicable, and agents, representatives, successors and assigns thereof do hereby forever release, waive and acquit, Husqvarna, its officers, directors, employees, agents, successors and assigns from and against any and all claims, lawsuits, demands, liabilities and obligations arising in connection with, or relating to, my submission of the Idea and all of my disclosures relating to the Idea to Husqvarna. Unless otherwise explicitly agreed in writing by a subsequent, separate document or agreement, these terms shall apply to all of my disclosures to Husqvarna relating to the Idea. The terms and conditions set out in this Patent Information Declaration shall not be modified or waived except in writing signed by Husqvarna.
Address Husqvarna AB (publ) SE-104 25 Stockholm Sweden Visiting address Telephone Fax Reg. No. Web site
S:t Göransgatan 143 +46-3614 65 00
+46-88739 64 50
556000-5331
www.husqvarna.com
This Patent Information Declaration shall be governed and construed in accordance the substantive laws of Sweden, without regard to the choice of law principles thereof. Any dispute, controversy or claim arising out of or in connection with this Patent Information Declaration, or the breach, termination or invalidity thereof, shall be settled by arbitration in accordance with the Rules of the Arbitration Institute of the Stockholm Chamber of Commerce. The arbitral proceedings shall be held in Stockholm, Sweden, and be conducted in the English language. If the patent or the published patent application is assigned, the owner(s) of the entire interest of the rights of the patent or the published patent application must sign. If the patent or the published patent application is not assigned, all of the named inventors must sign. Use additional Patent Information Declaration forms as needed.
Signature of Submitter Name of Submitter Title or Office (if applicable) Corporate entity (if applicable) Date: Full address of Submitter: Location signed at:
Telephone contact: E-mail contact:
NOTE: Retain the enclosed duplicate copy of this Information Declaration for your files and return an entire completed Information Declaration to Husqvarna at: To: Husqvarna AB EM-LPH SE-561 82 Huskvarna SWEDEN
Do not send a copy of the patent or published patent application or any other documentation or materials pertaining to your idea. A copy of your patent or published patent application will be obtained directly from the relevant patent and trademark office.
Address Husqvarna AB (publ) SE-104 25 Stockholm Sweden
Visiting address
Telephone
Fax
Reg. No.
Web site
S:t Göransgatan 143 +46-3614 65 00
+46-88739 64 50
556000-5331
www.husqvarna.com