invention disclosure form - Technologie Lizenz Büro
invention disclosure form - Technologie Lizenz Büro
invention disclosure form - Technologie Lizenz Büro
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REPORT OF INVENTION<br />
Please send a copy to<br />
An die<br />
Abteilung <strong>Technologie</strong>transfer der<br />
Universität/Hochschule<br />
An die<br />
<strong>Technologie</strong>-<strong>Lizenz</strong>-Büro (TLB)<br />
der Baden-Württembergischen Hochschulen GmbH<br />
Ettlinger Straße 25<br />
76137 Karlsruhe<br />
P L E A S E M A I L I N A S E A L E D E N V E L O P E !<br />
PLEASE DO NOT FILL IN!<br />
Eingegangen am:<br />
Mitteilung über Unvollständigkeit am:<br />
Vollständiger Eingang am:<br />
1. Title of the Invention:<br />
2. Persons who have contributed to the Invention as inventors:<br />
Notice: All mentioned inventors have to sign the Report of Invention<br />
(see page 3) !!!<br />
Inventor 1 Inventor 2 Inventor 3 Inventor 4<br />
Name<br />
Occupation<br />
Title/ academic<br />
degree<br />
Institute/Lehrstuhl<br />
: (Office,<br />
adress)<br />
Phone<br />
(Inst./Lehrstuhl)<br />
1
Email<br />
Home:<br />
(adress,<br />
phone)<br />
Nationality<br />
Percentage<br />
contribution to the<br />
<strong>invention</strong> (%)<br />
If there are more than four inventors, please attach the required in<strong>form</strong>ation on an additional sheet!!!<br />
3. Description of the Invention:<br />
Please give a short description of your <strong>invention</strong> (including all relevant citations) on an additional sheet (1-2<br />
pages) which covers the following issues:<br />
3.1. Which technical problem should be solved by your <strong>invention</strong>?<br />
3.2. What are the previous attempts to solve this problem? What is the prior art as known to you?<br />
3.3. What are the technical problems and/or disadvantages encountered with such prior art?<br />
3.4. What is the purpose of your <strong>invention</strong>?<br />
3.5. How does your <strong>invention</strong> accomplish this purpose?<br />
3.6. What are the essentially new features of your <strong>invention</strong>? What is the basic message of your <strong>invention</strong>?<br />
3.7. What essential and/or additional advantages does your <strong>invention</strong> have over the prior art?<br />
3.8. What are the keywords describing your <strong>invention</strong> (German and English)?<br />
4. Development of the <strong>invention</strong>:<br />
4.1. Did the <strong>invention</strong> arise within the scope of your regular working field or did it arise within a different<br />
area?<br />
(Please answer this question for each inventor separately.)<br />
4.2. Did the <strong>invention</strong> develop in connection with a diploma thesis, a doctoral thesis or a research project?<br />
(Please answer this question for each inventor separately.)<br />
2
4.3. Did you already publish anything in connection with the <strong>invention</strong>?<br />
(Please attach copies of relevant documents.)<br />
Do you intend to do any publications, presentations or other releases any time soon? (If so, when,<br />
where and what about?)<br />
4.4. Has the <strong>invention</strong> or parts of the <strong>invention</strong> been made known to the public in any <strong>form</strong> (in written or oral<br />
<strong>form</strong>, lectures, lab visits, fairs, exhibitions)? If so, when and where?<br />
4.5 Date of completion of the <strong>invention</strong>? (Please answer this question for each inventor separately)<br />
5. Development status:<br />
5.1. Has the <strong>invention</strong> been tested or has it been used?<br />
(Tests, samples, prototypes)<br />
5.2. Are there contacts with the industry in connection with your <strong>invention</strong>? If so, please list the companies.<br />
I (we) declare that the in<strong>form</strong>ation which I (we) have provided in this <strong>form</strong> is, to the best of my (our)<br />
knowledge and belief, correct and complete, that I (we) have developed the <strong>invention</strong>, and that no other<br />
person(s) than the person(s) listed in section 2 has/have contributed to the <strong>invention</strong> as inventor(s).<br />
…......................................., date .......................<br />
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3
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4
Erklärung des Institutsleiters (Declaration of the Principal)<br />
Für die Bewertung der rechtlichen und vertraglichen Rahmenbedingungen der vorliegenden Erfindung wird um<br />
die Beantwortung der folgenden Fragen gebeten:<br />
1. Entstand die Erfindung im Rahmen eines drittmittelgeförderten Projekts ?<br />
(z. B. DFG, BMBF, EU, Industriekooperationen, Forschungsaufträge)<br />
Wenn ja, geben Sie bitte die genaue Bezeichnung der zugrundeliegenden Verträge an !<br />
Bitte legen Sie Kopien der entsprechenden Verträge bei !<br />
2. Welche besonderen Mittel wurden für die Entwicklung der Erfindung aufgewendet ?<br />
3. Die Angaben in der Erfindungsmeldung wurden überprüft und erschienen einwandfrei.<br />
............................................, den .......................<br />
............................................................................<br />
...............................................................................<br />
Unterschrift des Institutsleiters<br />
Institutsstempel<br />
5
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