Fill in Confidentially Disclosure - PDF by fdg78416

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									                                  Registered Patent Attorneys
                                     www.LicensingLaw.Net


55 Madison Avenue, 4th floor (P 4014)                       Practice limited to Domestic & International
Morristown, NJ 07960-7397 USA /Etats Unis                   Pharmaceutical Patent law and licensing




                             PATENTABILITY SEARCH
                            INVENTION DISCLOSURE FORM
                                   CONFIDENTIAL

INSTRUCTIONS: Please fill out this form as completely as possible. If more space is needed,
feel free to attach additional sheets. Please affix attachments and deliver Confidentially to the
Firm, along with the appropriate fee for a patentability search.

Title of Invention:

Category and General Description. Is the invention a new process, composition of matter, a
device, or one or more products? A new use for, or an improvement to, an existing product or
process?




Utility. What are possible uses for the invention? In addition to immediate applications, are
there any other uses that might be realized in the future?




Novelty. Pick out and expand on novel and unusual features. What is the presently-existing
technology? How does the invention differ from present technology? What problems does the
invention solve, or what advantage does it possess, compared to previously existing
technology?




                         Registered Patent Attorneys, Pohl & Assoc. LLP
                                  Telecopier +1 (973) 665-9152
                                Invention Disclosure Form
                                            Page 2




Method of Synthesis, Assembly, or Process. If the invention is a composition of matter, a
device, or a product, how is it made? If the invention is a process, what are the steps
involved? What is your best guess of how much this would cost, if done commercially?




Limitations. Does this invention possess disadvantages or limitations?            Can they be
overcome? How?




Experimental Verification. Have you tested the invention experimentally? YES___ NO___         If
yes, describe below, or, if available, you may attach a draft scientific paper describing these
results.




Have you constructed a prototype, model, or test samples which are available for examination?
YES ___ NO ___. If yes, describe below.
                                Invention Disclosure Form
                                            Page 3



Prior Publications. Have you described the invention in a publication or an oral presentation?
What was the date of publication or presentation? Was it described in a specific or general
fashion? Include poster presentations, abstracts of talks, investor presentations, interviews
for news stories, etc. Be sure to provide copies of any publications, label them collectively as
attachment A.




References. What papers and patents (your own and others) are most closely related to this
invention? Please list them below, and attach copies if available. Label the copies collectively
as attachment C.




Sponsorship. Was the work that led to the invention sponsored by a third party? List sponsors
below, and attach copies of research contracts or grant agreements if available. Label these
collectively as attachment E.



                                                                                       Copy
                                                                                    Included
           Research Financing Source                        Contract Date             (Y/N)
                                Invention Disclosure Form
                                             Page 4




Name of Inventor:      _________________________________________________

Inventors’ Employer:          _______________________________________

Inventor's Title (if Graduate Student, please indicate):

   _______________________________________________________________

Inventor's Work Address:_______________________________________

Inventor's Work Phone: __________________ HOME:______________

Inventor's Home Address:      ______________________________________

                       _______________________________________

Signature of Inventor:___________________________ Date: ______________




Name of Inventor:      _________________________________________________

Inventors’ Employer:          _______________________________________

Inventor's Title (if Graduate Student, please indicate):

   _______________________________________________________________
                                Invention Disclosure Form
                                             Page 5



Inventor's Work Address:_______________________________________

Inventor's Work Phone: __________________ HOME:______________

Inventor's Home Address:      ______________________________________

                       _______________________________________

Signature of Inventor:___________________________ Date: _ _____________




Name of Inventor:      _________________________________________________

Inventors’ Employer:          _______________________________________

Inventor's Title (if Graduate Student, please indicate):

   _______________________________________________________________

Inventor's Work Address:_______________________________________

Inventor's Work Phone: __________________ HOME:______________

Inventor's Home Address:      ______________________________________

                       _______________________________________

Signature of Inventor:___________________________ Date: ______________



PLEASE HAVE THIS FORM WITNESSED BY SOMEONE WHO KNOWS AND UNDERSTANDS THE
INVENTION.

WITNESS:______________________________

PRINTED NAME:___________________________

DATE: __________________________________
                                Invention Disclosure Form
                                             Page 6



                                 INVENTION QUESTIONNAIRE

INSTRUCTIONS: Please fill out this form as completely as possible. If more space is needed,
feel free to attach additional sheets. You may amend it at a later time if you wish. Please affix
attachments and deliver in confidence to the Firm.

WHEN COMPLETED, THIS DOCUMENT IS CONFIDENTIAL. PLEASE DO NOT DISTRIBUTE.



Inventor, Title:



Abstract. Please provide a brief abstract of the invention. PLEASE NOTE, THIS ABSTRACT IS
INTENDED FOR MARKETING PURPOSES UNDER NONCONFIDENTIAL SITUATIONS. While it is
important to include the novel nature of the invention, a general description, intended or
proposed uses and utility, the abstract should be NON-ENABLING (i.e., it should not include
detail sufficient to “enable” someone to reproduce or replicate the invention).




Possible Means of Commercialization. How do you envision that the invention might be used
in a commercial product or a process for producing a product? Feel free to include as many
possibilities as you can. What advantages does this invention have over existing technologies?
                              Invention Disclosure Form
                                           Page 7




Potential Licensees. Have you described the invention to industry representatives? Did you
describe it in a specific or a general fashion? Did they express any interest? Name
companies and specific individuals and their titles. Do you know of other firms that might be
particularly interested?

								
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