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Invention Disclosure Form
Please allow at least 45 minutes for the completion of this form as it becomes an important legal document useful in proving priority of invention when completely executed.
21
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1
Descriptive Invention Title
*
This field is required.
The patent title should be descriptive of the invention to which the claims are directed. If the title is not considered descriptive, the Patent Office Examiner may require a new title. The patent title must not exceed 500 characters in length and must be as short and as specific and descriptive as possible. The title should be one that is easily searchable using a few keywords during a patent search.
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2
Inventor 1 Details
*
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Inventor 1 Name
Inventor 1 Address
City
Zip Code
Inventor 1 Mobile Phone
Inventor 1 Email
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3
Inventor Name (For OneDrive)
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4
Inventor 2 Details
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Inventor 2 Name
Inventor 2 Address
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Inventor 2 Mobile Phone
Inventor 2 Email
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5
Inventor 3 Details
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Inventor 3 Name
Inventor 3 Address
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Inventor 3 Mobile Phone
Inventor 3 Email
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6
1c. Owner
*
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Do the inventor(s) that you listed in the previous questions own the patent rights to this invention? If you answered "No," please identify the owner of the invention below including the state/country of organization for the company along with the company's mailing address
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7
1d. Prior Public Disclosure
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Identify any past use, sale, display or publication of the invention (include dates).
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8
1e. Related Patents or Applications
*
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List any related patents or patent applications of yours.
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9
2a. Purpose
*
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What does the invention do?
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10
2b. Prior Existing Technology
*
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Describe previous methods, materials, or apparatus used by others to perform the purpose of the invention and give their limitations/disadvantages.
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11
2c. Physical Structure
*
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Describe the physical structure of your invention (if applicable). Sketches, photos, or other illustrations should be attached to this form to fully illustrate your invention. In the description of the physical structure, use reference characters to refer to refer to components in attached illustrations.
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12
2d. Operation/Function/Use
*
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Give a detailed description of the invention's operation, function and use.
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13
2e. Alternatives
*
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Indicate any alternative or additional methods, materials, or apparatus of the invention.
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14
2f. New Features
*
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Identify all novel features of the invention
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15
2g. Advantages
*
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State the advantages of the invention over the Prior Existing Technology described in paragraph 2b (Prior Existing Technology).
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16
Does your company qualify for micro-entity status with the USTPO?
*
This field is required.
The "Maximum Qualifying Gross Income" for purposes of paying any eligible fee at the micro entity discount rate is currently $206,109.
Click here to learn more about qualifying for micro-entity status.
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NO
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17
Please click here to download
the Certification of Micro-Entity Status form.
After downloading please fill in your information, print, sign, scan and upload below.
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18
Do you or an inventor qualify for a petition to make special based on age or health?
*
This field is required.
The criteria for a petition to make special on the basis of age or health are set forth in 37 CFR 1.102, MPEP § 708.02.
Click here to learn more about qualifying for a petition to make special.
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NO
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19
Please click here to download
the Petition To Make Special Based on Age/Heath form.
After downloading please fill in your information, print, sign, scan and upload below.
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: 10.6MB
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20
Person Submitting The Form
*
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First Name
Last Name
Email
Business Phone
Cell Phone
Mailing Address
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21
Please upload any corresponding documents you would like to share.
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22
I confirm that the details in this invention disclosure form are accurate.
*
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Please draw your signature below.
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