OU ID #

OHIO UNIVERSITY

Software Invention Report

Your invention, or idea is important (1) to your professional development; (2) to your department, college and the University; and, if applicable, (3) to your research sponsor. It is essential that it be reported promptly, so that it can be evaluated to determine if it can or should be patented or copyrighted and reviewed for commercial potential to justify an industry licensing program. For additional information about the Ohio University commercialization policy see Policy & Procedure 17.001.

Please fill out all the items that apply to your invention accurately and return the document with original signature(s) to the Technology Transfer Office (TTO). If you need assistance with filling out this form, please contact the TTO at

740-593-1778. Do not send this information through e-mail.

  1. Inventor Information

# / Full Legal Name / Title (e.g. Professor) / College / Department / Tel. Number / Department Chair
1
2
3
4
5
2. Software Title:
3. Funding Sources: Please list all funding sources for materials, equipment and/or salaries of all personnel involved in conception and development of the invention.

Funding Source

/ Name of Department, Company, Agency etc. (e.g. NIH, Huntsman, ARUP, HHMI, VA, CBI) / Grant or Account number
Unrestricted University/Departmental
Federal/other government agencies 1
Federal/other government agencies 2
Private/public foundation (e.g. HCF)
Commercial entity
Others (Please Specify)
4. Briefly Summarize the Software: Please use extra space if needed and append complete descriptions (e.g. data, publications, screen shots)
5. Has any proprietary or open source code been used in this software?
6. URL of the project?
7. Please Indicate the Stage of Development of Your Software: (planning, pre-alpha, alpha, beta, production/stable, mature, or inactive) Is this a new version of previously disclosed software?
8. In what programming languages is the software written?
9. Are there required libraries? Please list
10. What is the User interface?
11. What is the software's intended audience?
12. How many people do you believe are using/ will be using your software?
13. On what Operating Systems will this software work?
14. With which Databases will this software work?
15. Is this source code in executable format? If it is not, please include build instructions.
16. Do you plan on continuing work on this software or providing continued support for the software?
17. Please Identify Any Students Whom Contributed to the Conception and/or Development of Software. (List Names)

I (We) hereby assign all right, title and interest to this invention to Ohio University and agree to execute all documents as requested, assigning to Ohio University our rights in any patent application filed on this invention, and to cooperate with the Ohio University Technology Transfer Office in the protection and commercialization of this invention. Ohio University will share any royalty income derived from the invention with the inventor(s) according to its standard policies, as may be updated from time to time. If there are more than five inventors, please attach an additional form.

Primary Contact

Inventor 1 Name:
Citizenship:
Home Address:
Work Address:
Phone:
E-mail:
Signature: Date:
Inventor 2 Name: / Inventor 3 Name:
Citizenship: / Citizenship:
Home Address: / Home Address:
Work Address: / Work Address:
Phone: / Phone:
E-mail: / E-mail:
Signature: Date: / Signature: Date:
Inventor 4 Name: / Inventor 5 Name:
Citizenship: / Citizenship:
Home Address: / Home Address:
Work Address: / Work Address:
Phone: / Phone:
E-mail: / E-mail:
Signature: Date: / Signature: Date:

1