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 toTexas A&M Technology Commercialization at

Title of Invention:

*Lead Inventor:

*(For purposes of this disclosure, please designate a person that is currently employed by TAMUS.)

Other TAMUS Inventor(s):

Non-TAMUS Inventor(s):

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.

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]

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.

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.).

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.

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.

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

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.

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 invention’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.

If internal resources were used in the development of this invention, please indicate the System member(s) through which the funds were provided (e.g. AgriLife, TAMU, TEES, etc.):
Please list all sources of funding used in the conception and development of the disclosed invention; include grant numbers or other unique, assigned identifiers for each in the table below:

Name of Funding Agency/Entity / Federal Grant / Agreement
/ Contract / or Other Type of Award No. / Internal Acct. No. or Other Type of Internal Reference No. / Contracts & Grants Office managing award (e.g. AgriLife, TAMU, SRS, TEES, etc.)

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DISCLOSURE OF INVENTION

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 invention and whether a Material Transfer Agreement, Nondisclosure Agreement, license or other agreement was required to obtain the materials/information.

Check all that apply:

15.a / Yes No / This disclosure is required by, or motivated by, the terms of a sponsored research agreement or other contract
If you answered “Yes” to 15.a, for each relevant agreement list the name of the party with which the agreement or contract has been made.
15.b / Yes No / There is a publication or other public/non-confidential release of information on this invention planned in the near future.
If you answered “Yes” to 15.b, provide a list of all planned publications and dates.
15.c / Yes No / This disclosure was requested by the TTC.
If you answered “Yes” to 15.c, provide the names of the requestor(s).
15.d / Yes No / This disclosure was requested by department head, research administration or other TAMUS official.
If you answered “Yes” to 15.d, provide the names of the requestor(s).
15.e / Yes No / This was co-invented this with someone in another university or other organization, and they have requested that this be disclosed.
If you answered “Yes” to 15.e, provide the names and contact information for the requestor(s).
15.f / Yes No / There is a planned discussion with a potential licensee, investor or research sponsor regarding this invention.
If you answered “Yes” to 15.f, provide details regarding this planned discussion.

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DISCLOSURE OF INVENTION

15.g / Yes No / Do you see yourself having a role in commercializing this invention?
If you answered Yes to 15.g please describe what you envision your role might be.
15.h / Yes No / There is a desire to create or work with a start-up company that would make use of this invention.
If you answered “Yes” to 15.h, provide details regarding this potential objective.
15.i / Yes No / Have you spoken to a System-contracted attorney regarding this invention?
If you answered “Yes” to 15.i, please provide the law firm and name of person you spoke with.

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 TTC to understand if the inventionthat is the subject of this disclosure is controlled by export regulations.

Please address the following questions for this purpose:

To the best of your knowledge, is the inventionbeing 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:

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

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DISCLOSURE OF INVENTION

Does your disclosure involve actual technology that has been completed or is the inventiononly theoretical?

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

Are there any publication restrictions in your grant or contract?

If you are unsure if the inventionthat 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 .

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DISCLOSURE OF INVENTION

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 invention.

Inventor:

First: MI: Last:

Ms. Mrs. Mr.

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:

Work Address: / Home Address:
street address / street address
city/state/zip / city/state/zip
phone / phone
fax / fax
work email / home email

TAMUS 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 inventionor discovery? YES NO

TAMUS Member (AgriLife, TAMU, TEES, TTI, TAMU-Kingsville, TAMU-Corpus Christi, etc.):

Department/Division:

Laboratory or Center:

Non-TAMUS Employment Status/Title (for non-TAMUSinventors 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, but still must be named on this page. Please also indicate each inventor’s percentage of contribution to the disclosed invention.

Title of Disclosure:
Inventor Signatures:
I/We certify that the information in this Disclosure of Inventionis complete and accurate.
Printed Name: / % Contribution* / Date
Printed Name: / % Contribution / Date
Printed Name: / % Contribution / Date
Printed Name: / % Contribution / Date
Printed Name: / % Contribution / Date
Printed Name: / % Contribution / Date
Witness Signature (optional):
Disclosed to and understood by me this day of "MONTH", "YEAR".
Printed Name:

*All TAMUS-inventors must also complete the “Agreement for Distribution of Licensing Income for Invention” form on the following page. The above percentages are not intended for purposes of TAMUS distribution of licensing income.

Please submit this completed form, including all Inventor Data Sheet(s) and signatures where applicable, to or mail to:

Texas A&M Technology Commercialization / Attn: Disclosure of Invention

3369 TAMU / College Station, TX 77843-3369

AGREEMENT FOR DISTRIBUTION OF LICENSING INCOME FOR INVENTION

For completion by TAMUS-employed inventors only (currently employed or employed by TAMUS at the time of the inventor’s contribution to the invention).

We/I, the undersigned, as named TAMUS inventor(s) on the subject invention, agree and acknowledge that:

(i)licensing income generated by this invention which accrues to named inventor(s) under The Texas A&M University System (TAMUS) Policy 17.01, Intellectual Property Management and Commercialization, should be distributed to the named inventor(s) in the proportions designated below;

(ii)if a named inventor is determined not to be an inventor under relevant laws (an “excluded inventor”), the excluded inventor is not eligible for licensing income distribution;

(iii)notifications of address changes must be provided to the TTC; and

(iv)in the event the inventors are unable to agree upon an appropriate sharing arrangement amongst themselves, the sharing portions will be decided by the inventors’ member CEO and this decision will be binding on the inventors.

Agreement for Distribution of Licensing Income for
Title of Disclosure of Invention:
Inventor Name (printed) / Inventor Signature / *Percentage / Date

*Percentages should total 100%

GUIDELINES

You may contact Texas A&M Technology Commercialization for a consultation prior to submitting your invention. Please contact us at 979-847-8682 or visit our website at

If you have never submitted a disclosure of invention before, it is recommended that you contact Texas A&M Technology Commercialization to arrange a consultation.
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 TTC website.
Please be advised that your disclosure 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 TTC for a consultation.
In the event that your disclosure 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 disclosure 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.
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 disclosure will be returned for completion.
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).
After submitting your disclosure of invention, 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 TTC, the disclosure will be assigned to a project manager and you will be notified.
As per TAMUS Policy 17.01, the TTC will make a decision regarding your disclosure 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.

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[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