NOTE: This EERE 358: U.S. Manufacturing Report template is provided as a convenient method of documenting the progress in implementing the U.S. Manufacturing Plan submitted as part of the full application for award funding. The use of the U.S. Manufacturing Report template is not required, but the data elements within the U.S. Manufacturing Report template are required.
INSTRUCTIONS
Organizations (e.g., recipients and contractors, at all tiers) that submit a U.S. Manufacturing Plan as part of their application for funding from the Office of Energy Efficiency and Renewable Energy (EERE), U.S. Department of Energy and are asserting any intellectual property protection (see further below for limited exceptions) over any part of the results from their funding agreements (referred to herein as “Protected Results”) are required to submit annual reports on compliance with the Plan for 5 years from the end date of the funding agreement.
Please upload this report to:
https://www.eere-pmc.energy.gov/SubmitReports.aspx
For the purpose of this report, intellectual property protection includes marking data as Protected Data, as defined in 10 CFR 600.325 Appendix A or asserting copyright protection on any works developed under the funding agreement, other than scientific and technical articles or in software that will be licensed as open source. If you are submitting Invention Utilization Reports, this U.S. Manufacturing Report is not required.
If additional space is required to complete any fields, please append additional pages to this form.

SECTION A. GENERAL INFORMATION

Submitting Organization:

Reporting Period:

Provide the time period from the latter of the last U.S. Manufacturing Report regarding the Protected Results and the date of the present Report.

Brief description of the Protected Results (e.g., copyright software, Protected Data regarding process improvements):

SECTION B. PROTECTED RESULTS STATUS

1.  Provide a brief update on any developments to use or build upon the Protected Results since your last report.

2.  Provide a brief description of your efforts to commercialize and market the Protected Results, e.g., seeking technology maturation funding; attempting to license; seeking suppliers, manufacturers, resellers, distributors or other partners.

3.  Describe any industrial applications for the Protected Results.

4.  Has the Protected Results been commercialized, i.e., is there any commercially available product or service that embodies or is made through the use of the Protected Results? If yes, identify the products and services (specific capabilities and performance improvements enabled by EERE-sponsored efforts), and provide the name(s) of the product or service. Also, what existing processes compete with or are replaced by the Protected Results?

5.  If the Protected Results has been commercialized, what is the date of its first commercial sale or use? If any partners are involved in the commercialization effort, please identify them and describe their unique contribution.

6.  What are the gross sales revenues to date for products and services that embody or are made through the use of the Protected Results? How many units have been installed or sold (not including orders)?

7.  If the Protected Results has been assigned to another entity, please provide the name of the entity and any fee for the assignment.

SECTION C. BENEFITS TO U.S. ECONOMY AND U.S. MANUFACTURING

8.  List activities conducted in the U.S. that support the commercialization of the Protected Results (e.g. research and development, administration, manufacturing, Government policies - federal, state and local).

9.  If applicable, provide an approximate number of U.S. gross jobs created or retained as a result of the funding agreement, including startups, material suppliers, systems integrators, distributors, users, service providers, as well as manufacturers. Have any new startups, including companies using the technology and domestic suppliers, been created because of this invention?

10. Provide a list of manufacturing plants or facilities with locations that use the Protected Results or manufacture or assemble products that embody the Protected Results.

11. Describe how the development and commercialization efforts of the Protected Results further and are in compliance with that U.S. Manufacturing Plan submitted as part of the application that led to the funding agreement.

SECTION D. LICENSING EFFORTS

11.  Has the Protected Results been licensed, either on its own or bundled with other tangible or intellectual property? Yes No

a.  If no, you may skip the remainder of this section.

b.  If yes, provide the amount of gross royalties from the license to date. $

c.  If yes, provide the total income received as a result of license or option agreements related to the Protected Results during this reporting period? $

d.  If yes, provide the license identification number:

12.  During this reporting period, did any entity (e.g., contractor, licensee) request a waiver of any U.S. manufacturing requirements related to the Protected Results? Yes No

If yes, how many waivers were obtained?

13.  During this reporting period, how many exclusive licenses or options for the Protected Results existed? List them and the associated licensing numbers.

14.  What is the number of domestic manufacturing licenses for the Protected Results?

15.  During this reporting period, how many non-exclusive licenses or options for the Protected Results existed?

16.  During this reporting period, how many licenses or options of any type to small businesses (<500 employees) are active?

SIGNATURE OF AUTHORIZED REPRESENTATIVE

I certify that I have the authority to approve, and I do so hereby approve, the submission of this completed form on behalf of the organization named below to the U.S. Department of Energy.

Authorized Representative (Typed) Signature
Organization
Business Address
Telephone Number
Email
Date

5