If you prefer, you may answer these questions using this downloadable Word document. Please enable JavaScript in your browser to complete this form.Name *FirstLastCompany or InstitutionType "individual" if there are no current obligations to assign to an institution or corporation.PhoneEmail *AddressAddress Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeInvention DetailsInvention titleShort title to your inventionSummary of inventionPlease describe the invention briefly. If possible, attach a manuscript, a research proposal, a sketch (with all elements numbered and described herein), a drawing or any other materials that would assist in the understanding of the invention. Document and Figure Upload Click or drag files to this area to upload. You can upload up to 8 files. Attach any documentation or figures explaining invention. PDF, Word, JPG, PNG and PowerPoint accepted.Reduced to practice (produced or in prototype form)? First ChoiceHas the invention been reduced to practice?Date / TimeWhen was the invention reduced to practice?Closest prior artIdentify and describe the closest technological development, either in the U.S. or abroad, that you are aware of. Such technology may have been described in any patent or publication, or presented at a public talk or trade fair, or be on sale now or in the past or near future. Concurrent developmentDo you know if anyone else has invented something similar which is not yet publicly available? If so, please identify and describe it. Advantages over prior artPlease specify the differences between your invention and the closest prior technology. What advantages does your invention provide over the prior technology? What defect(s) does it overcome? What problem does it solve? Uses of inventionWhat are all possible uses for the invention? Please speculate reasonably on any additional uses that your invention may have, either by itself or in combination with other known, or as yet unknown, technology.Optimum parameters of the inventionWhat is (or are) the best way (or ways) of carrying out your invention? (Include in the description any peculiar, necessary or unusual properties, characteristics or functions of such parts of the invention and any other special conditions, such as temperature, pressure, dimensions, proportions and the like, which are important to the operativeness of the attainment of the purpose of the invention. Include any chemical formula or electrical computation necessary to an understanding of the invention. Attach hereto all original and preliminary written descriptions of this invention.) If a product (chemical or otherwise), what are the optimum materials and proportions? If a process, what are the optimum conditions and parameters?Invention limitationsAre there any disadvantages or problems with your invention? Can they be overcome? How?Related authorshipYes, there is related work.Have you or any of your collaborators described this invention or a similar invention in whole or part in manuscripts, reports, grant applications, theses, abstracts, oral presentations, demonstrations, or sales catalogues? If so, describe each event with dates and authors. Related work detailsPlease explain related work. Related patent applicationsYesHave any patent applications been filed on closely related inventions? Identify them, if possible. Related patent application detailsPlease include filing dates and serial numbers if available.Has there been a public use or an offer for sale?Sold previouslyShown publiclyOffered publiclyOffered privatelyNever any disclosure outside confidentiality circlePrior disclosures or sales are critical and strongly affect what patent rights are available. First public disclosure or offer to sell/licensePlanning disclosure of invention in the future?YesAre you planning any disclosure of the invention in the future? Is there any imminent publication, or oral presentation, or showing or offer of sampling or sale of the invention? Date of anticipated disclosure or first saleWho sponsored or paid for the work that led to the invention or part thereof? Foreign marketsYesWould the invention have market potential in countries other than the U.S.? Which countries? Foreign countries of interestWhich countries would the invention have potentialSignatureClear SignatureI believe in good faith that the foregoing information is true and accurateCustom Captcha * = Submit Share this:Click to share on LinkedIn (Opens in new window)Click to share on Facebook (Opens in new window)Click to share on Twitter (Opens in new window)Click to share on Tumblr (Opens in new window)MoreClick to share on Pinterest (Opens in new window)Click to email a link to a friend (Opens in new window)Click to print (Opens in new window)
