Commercialization Proposal Form / Invention Disclosure

Commercialization Proposal Form / Invention Disclosure

This form is used to disclose new inventions for assessment and possible commercialization and to meet obligations of disclosure as required under TAMUS Policy 17.01. Before completing this form, please refer to the guidelines at the end of this document. Please send your completed form, inventor data sheet(s), and any additional documentation to .

1. Title:

1. Lead Inventor: (Inventor Data Sheet required)

1. Abstract: Describe the invention and what it can be used for in 500 words or less. The description should be accessible to a “lay audience” having no special or expert knowledge in your field.

1. Other TAMUS Inventor(s): (Inventor Data Sheet required for each inventor)

1.

2.

3.

4.

5.

1. Other Non-TAMUS Inventor(s): (Inventor Data Sheet required for each inventor)

1.

2.

3.

1. Utility: Describe your vision for how this invention could be used to create a commercial product[1] or service[2] or how it could be used in industry.[3]

1. Significance: Why would commercialization of this invention be important? Describe the benefits that could be realized if this invention were used to create a product or service or if it were used in industry.

1. Novel Aspects: What are the novel features of your invention compared to what has been previously reported in the literature (e.g. scientific journals, published patent applications, issued patents)? You are invited to speculate here as to why this invention has not been made before (e.g. breakthroughs, new observations, innovative synthesis of existing data, etc.).

1. Enablement: Please provide a detailed description of howyour invention would be made or practiced. If additional experimentation is needed to determine any aspects of how your invention would be made or practiced, please describe.

1. Stage of Development:

a. Please provide the earliest date of conception (as close as possible):

b. Please summarize results you have obtained that support the idea that this invention is feasible and can work. If you have developed a prototype, please also describe the prototype.

1. Future Plans: Do you plan to continue developing or working with this technology? If so,please describe your goals and next steps.

1. Past Public Disclosures: List all external disclosures of information about this invention regardless of form. Examples of forms of disclosure include journal articles, submitted manuscripts, abstracts, theses, public presentations, web pages, posters, consultations, emails, and verbal and written discussions; in each case, this is with respect to disclosures with parties outside of TAMUS.

1. Funding: Rights in technologies may be impacted by, or obligated under, the terms of agreements with entities that provided the funding that led to the technology’s development. Examples of entities that provide funding under agreements include, but are not limited to, federal agencies, state agencies, non-profit research foundations, commodity boards, private companies, industry associations/organizations, and providers of gift contributions.

1. If no funding provided under a funding agreement was used to develop this invention, please indicate so by checking this box and proceed to question 14. Otherwise, proceed to question 13.b.
   
2. Please list all sources of funding used in the conception and development of the disclosed technology/discovery; include grant numbers or other unique, assigned identifiers for each.
   

1

Form Revised 09/20/2012-Version 13.1

1. Other Contractual Obligations:Rights in technologiesmay be impacted by materials of others used to develop them (e.g. materials obtained under a Material Transfer Agreement; materials sent by a colleague at another institution; purchased materials for which there was a purchase agreement; information obtained under a Nondisclosure Agreement; information received from an outside party under terms of confidentiality; software received under a license from an outside party). Please list all sources of materials/information used in the conception and development of this technology or discovery and whether a Material Transfer Agreement, Nondisclosure Agreement, license or other agreement was required to obtain the materials/information.

1. Check all that apply:

1

Form Revised 09/20/2012-Version 13.1

1. Export Control. THIS SECTION MUST BE COMPLETED. The Texas A&M University System (TAMUS) has an obligation to implement an export control compliance program to reduce the risk of export control violations. All employees and students must be aware of and are responsible for the export control implications of their work and must ensure their activities conform to export control laws and regulations. There are severe institutional and individual sanctions for violations of export control laws and regulations, including the loss of research funding, loss of export privileges, as well as criminal and civil penalties. It is important for OTC to understand if the technology that is the subject of this disclosure is controlled by export regulations.

Please address the following questions for this purpose:

1. To the best of your knowledge, is the technology being disclosed or the technical information in the disclosure subject to US export Control laws including, without limitation, those implemented by the Department of Commerce through its Export Administration Regulations (EAR)[4] and the Department of State through its International Traffic in Arms Regulations (ITAR)[5], as well as those imposed by the Treasury Department through its Office of Foreign Assets Control (OFAC)[6]?

YES NO

If yes, please explain:

1. What is your item made of? (Please provide a list of components, chemicals, etc.)

1

Form Revised 09/20/2012-Version 13.1

1. Does your disclosure involve actual technology that has been completed or is the technology only theoretical?

1. Was there any language in your grant that prohibits the participation of foreign nationals?

1. Are there any publication restrictions in your grant or contract?

If you are unsure if the technology that is the subject of the disclosure is subject to export control, please check with the Office of Research Compliance. The Office of Research Compliance (ORC) maintains a website with export control information and resources at Additional information and resources regarding these and other regulations that impact university activities can be found at

Questions on export controls can be sent to .

1

Form Revised 09/20/2012-Version 13.1

Inventor Data Sheet

Please complete an Inventor Data Sheet for each named inventor including non-TAMUS inventors. Additional Inventor Data Sheets may be found at .

Contribution:

Briefly describe your contribution to the disclosed technology.

Inventor:

Preferred Salutation: Professor Dr. Ms. Mrs. Mr. Other

First: MI: Last:

PhD DVM MD MS/MA BS/BA Other:

Please name any joint appointments and/or affiliation that you have with another institution, including but not limited to joint appointments within TAMUS (if any):

University ID Number (UIN):

Country of Citizenship:

TAMU System Employment Status/Title (including former employees):

Professor Associate Professor Assistant Professor Employed Student

Other Status/Title (if not listed above):

Former Texas A&M University System Employee

If you checked “Former Texas A&M University System Employee,” were you employed by the A&M System at the time of technology or discovery? YES NO

System Component: (AgriLife, TAMU, TEES, TTI, Kingsville, Corpus Christi, etc.):

Department/Division:

Laboratory or Center:

Non-TAMU System Employment Status/Title (for non-System inventors only):

Please provide your Position/Title and Company Name:

Signature Page

Each named inventor must sign and date this page; non-TAMUS inventor signatures are optional. All inventors should be named on this page. Please also indicate each inventor’s percentage of contribution to the disclosed technology.

Please submit this completed form including all Inventor Data Sheet(s) and the signed Signature Page to or mail to

The Office of Technology Commercialization / Attn: Disclosure of Technology

3369 TAMU / College Station, TX 77843-3369

GUIDELINES

You may contact the Office of Technology Commercialization for a consultation prior to submitting your proposal. Please contact us at 979-847-8682 or by email at .

1. If you have never submitted a commercialization proposal / invention disclosure before, it is recommended that you contact the Office of Technology Commercialization to arrange a consultation about your proposal.
2. If you are disclosing a plant variety or plant germplasm, or software, please use the Plant Variety/Germplasm Disclosure Form or Software Disclosure Form as appropriate. These forms are available at the OTC website.
3. Please be advised that your proposal will be assessed on the basis of how your invention could enable a commercial opportunity. If you would like to discusscommercial applications of your invention, please contact the OTC for a consultation.
4. In the event that your proposal is accepted, it will become the subject of a commercialization plan, with the goal of achieving a licensing agreement with a company that will commercialize the invention. In the event that your proposal is not accepted, you will be informed and may elect to request a release of TAMUS rights in the invention such as it has been disclosed.
5. All questions must be answered and all inventor data sheets must be submitted. If any question is not answered or if there are missing inventor data sheets, the proposal will not be reviewed.
6. If you have supporting documentation that will further clarify the nature of the invention and/or the commercial opportunity, you may submit these along with the completed form and inventor data sheet(s).
7. After submitting your proposal, and after verifying that the form is complete, the form will be sent out for export controls review to determine whether the disclosure contains materials which are subject to export control regulations. When your disclosure is returned to the OTC, the proposal will be assigned to a project manager and you will be notified.
8. As per TAMUS Policy 17.01, the OTC will make a decision regarding your proposal within ninety (90) days. Since the assessment process is interactive, you can accelerate this process by meeting with the assigned project manager as soon as possible.

1

Form Revised 09/20/2012-Version 13.1

[1] Items of commerce, including but not limited to devices, therapeutics, catalysts, advanced materials, diagnostics, assays, and instrumentation.

[2] Commercial activities including but not limited to consulting, manufacture, analysis, processing, and design.

[3] Tools and methods that can be used to improve or enhance a company’s internal processes, including but not limited to quality control methods, decision-making tools, training, waste stream management, and manufacturing apparatus and methods.

[4] The Export Administration Regulations (EAR) 15 CFR 700-799 can be found at

[5] The International Traffic In Arms Regulations (ITAR) 22 CFR 120-130 can be found at

[6] The Office of Foreign Assets Control (OFAC) 31 CFR 500-599 can be found at