Please append any additional documentation that you consider relevant. You will be notified by the staff of the section of patent and Technology Transfer of their assessment of the invention and the strategy intends adopting to commercialise the invention.

1.Title of invention

2.  Type of Intellectual Property

3.  Inventors: Please list all inventors

4.  Contribution to the Invention

Each contributor/potential inventor should write a paragraph relating to his/her contribution and include a signature and date at the end of the paragraph. The summary should include whether the individual was for example involved in deciding on a general program me of work or designing particular experiments as well as whether he/she was involved in carrying out experimental work and the extent to which he/she was carrying out other peoples' instructions.

If there are more than five contributors, please affix additional pages.

5.  Description of Invention

6.Date of invention and public disclosure

Please include the following information

7.  Prior Art

Please include a short summary report of your prior art (patents and publications) search as an appendix to this DF. The report should list the closest related patents and publications. In the case of each item, please summarise that technology in a few lines and indicate why your invention is considered novel in comparison to that patent/paper.

Patent search tools you may wish to use include the following

1. Espacenet(eurpean); (https://www.epo.org/index.html
2. the US Patent office; http://patft.uspto.gov/
3. https://www.google.com/?tbm=pts
4. Free patents online http://www.freepatentsonline.com/search.html
   
    

8.  Sponsorship of research (if applicable)

If yes, please complete the following details. Please note accurate details are needed to fulfil UJIEC's obligations.

9.    Please list any companies that you think may be active in this area/ interested in the invention. Please also indicate also whether you have any contacts in these companies.

10.     Enclosures:

11.     Signatures and Approval

Inventors' Signatures

I/We acknowledge that I/We have read and understood this form andUA CEIE Intellectual Property and Technology Transfer Policy and have replied to the questions to the full extent of any knowledge available to me/us. 

I/We further agree to timely execute all assignments and other documents related to securing intellectual property protection and licensing of the invention and to otherwise cooperate with the Patent and Technology Transfer section and the patent attorney selected to handle this case. 

I/We also agree to make available to the UA CEIE, upon request, copies of lab notebooks and any other materials which contain information about the invention if applicable.

UACEIE Acknowledgement and approval

I acknowledge that this patent disclosure form was presented Excellence for Innovation and Entrepreneurship canter on the date indicated below.

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