INVENTION DISCLOSURE FORM Invention disclosure forms fulfill several functions. (i) It allows the Technology Transfer and Business Development Office (TTBDO) to assess the commercial potential of your invention or technology. (ii) It enables the TTBDO to plan intellectual property protection and to advise on the best route to market. (iii) It serves as a useful document in determining patentability and for doing freedom-to-operate due diligence (i.e., whether commercial exploitation of your invention/technology would require licenses from other parties). Kindly return the original Invention Disclosure For together with any supporting documents to: Technology Transfer and Business Development Office G/F National Institute for Molecular Biology and Biotechnology University of the Philippines Diliman, Quezon City 1101 Philippines Upon receipt of the form, the TTBDO will assess the commercial viability of your invention/technology and arrange a meeting with you to discuss your disclosure further, and to brief you on the policies and procedures of the university on intellectual property rights.1. TITLE OF INVENTION/TECHNOLOGYThe title should describe what the invention/technology does, but not how it is made or how it works/functions.2. SEARCH TERMS (up to 10)Please provide search terms that categorize your invention as to type of technology, industry and market segment it caters to, likely application, etc. This will aid the TTBDO in doing patent search as well as in due diligence to assess the commercial potential of your work.3.BRIEF OVERVIEW OF THE INVENTION (3-4 paragraphs)a) In layperson’s terms, please provide a short description of your invention/technology and how it works.b) What is the likely application of your invention? For example, “Which unmet need does it address, or which unexplored market does it target?”Is it a new product, process, or composition of matter? Or is it a new use for or improvement of an existing product, process or composition of matter?What benefits can the invention give? (Please use extra sheet/s if necessary.)TECHNICAL DESCRIPTION, DETAILS AND SUPPORTING DATAPlease provide data (proof-of-concept / functional data, where available) or other evidence which demonstrate how the invention works, or how your research findings can have commercial or industrial applications. You may attach papers, pilot projects or visual material, published or unpublished, in response to this question.PRIOR FINDINGS, METHODS, APPARATUS, or DEVELOPMENTSa) Findings, methods or apparatus in existence/reported closest to yours and the problems of each that the present disclosure solves.*b) Cite any of your own publications and patents, and those of anyone else believed by you to disclose ideas most closely related to the invention/research finding. Please attach all relevant publications, patents, advertisements, etc, if available. Please consult the TTBDO on how to do Prior Art Search.*6. STAGE OF DEVELOPMENT (2-3 paragraphs)Describe the development status (concept only, laboratory tested, prototype, etc) and briefly indicate what further development may be necessary to commercialize it7. POTENTIAL LICENSEES/CO-DEVELOPMENT PARTNERS/END-USERSIdentify companies or market segments that you think could benefit from your invention/findings.8. PUBLICATIONS/PRESENTATIONS/AND OTHER FORMS OF PUBLIC COMMUNICATION (DISCLOSURE)Please identify all past and future seminars, conferences, posters, abstracts, publications (including proceedings), web postings, and other venues wherein your work was or may be publicly disclosed. These may affect the scope of patent protection and the timing of filing. Kindly attach a copy of said publications or presentations. Disclosure is the oral, written, or electronic dissemination of the invention to a person outside the University of the Philippines that would enable someone of ordinary skill working in the field to practice the invention or repeat its development.Type of disclosure (i.e. publications, posters, etc)Date(s) 9. DATES OF CONCEPTION AND REDUCTION TO PRACTICE Note: The United States approved the switch from “first-to-invent” to “first-to-file” on September 16, 2011. It is anticipated that this will be followed for patent applications lodged on or after March 16, 2013. These dates have to be documented to respond to “first-to-invent” challenges in the case of multiple applicants for the same patent. Conception is the formulation in the mind of the inventors of the ultimate working invention. Simply put, reduction to practice means “when it was shown to work”. In the case of an invention, it is best to document the time of its physical creation as well. For intangible assets with commercial applications (e.g., biomarkers, drug targets), please provide the date they were identified/characterized and the date a function was assigned. Please attach additional sheets if necessary.DetailsDate(s) 10. SPONSORSHIPIdentify all grants, contracts, and other sources of funds (this includes research load credit provided by the University) contributing to the research that led to the invention. You should list all agencies that you would acknowledge in a publication. The TTBDO will check out the contractual reporting obligations associated with your funding. Kindly submit a copy of said agreements. In the event the agreements are UP agreements if you are unable to provide a copy please provide details that would enable our office to obtain copies of the same.Agency or SponsorGrant / Contract / Research Load Credit 11. OTHER AGREEMENTS AND INTERACTIONSIdentify any agreements or interactions that you have entered into that are related to the invention and might grant rights to a company or other party outside of the University (material transfer agreements, commercially sponsored research agreements, consortia agreements, consulting agreements, etc.). Kindly provide a copy of said agreements or documents evidencing said interactions.Did this invention use any materials which were obtained from a company or another institution? Yes No (Please provide details, and indicate if there is a Materials Transfer Agreement. Kindly attach a copy of relevant documentsDid you transfer to any researcher outside of your institution any new Materials (DNA, peptides, cell lines, vectors, catalysts, alloys, etc) related to the invention? Yes No (Please provide details)Is any other group, lab, or researcher on campus using your invention in their research program? Yes No (Please provide details)12. INVENTORS List all those who helped contribute to the conception of the ultimate working invention. The people you include ultimately may or may not be legal inventors. Please place an asterisk (*) next to the name of the inventor to whom correspondence should be sent. If any person holds a sole or joint appointment with any other university, company or governmental agency, please note that fact. Inventor* Citizenship* Dept/Affiliation* Position* Office Address Office Phone/Fax* Email Address* Home Address Home Phone* Cell Phone No.* Inventor* Citizenship* Dept/Affiliation* Office Address Position* Office Phone/Fax* Email Address* Home Address Home Phone* Cell Phone No.* If more, please upload a listMax. file size: 20 MB.I/We By disclosing this invention, I/We_______________________________________, the inventor(s), hereby agree and consent to such necessary and appropriate steps that the TTBDO may undertake in having this disclosure evaluated and in initiating a patent application. The TTBDO and its present, past and future staff, are hereby bound to confidentiality regarding any information disclosed herein. The TTBDO shall undertake to have confidentiality agreements executed by any other party to whom the TTBDO may give the information contained in this disclosure, for purposes of invention evaluation and patent application. “Invention evaluation” shall be understood to comprise the steps taken by the TTBDO to assess the marketability and patentability of the invention. “Patent application” shall include all processes related to patent application, such as but not limited to prior art searches and patent drafting. The CORRESPONDING INVENTOR should sign and date, along with his/her Department Head and College Dean.(Note: If that inventor is not the head of the laboratory, the signature of his/her faculty advisor or supervisor is required.) Corresponding Inventor Printed NameDate Department Head and College DeanDate 13. AGREEMENT REGARDING THE UP SYSTEM IP GUIDELINES I agree that by submitting this IDF, I am bound to the applicable Intellectual Property guidelines of the University of the Philippines System.Inventor’s NameDate
