RECORD OF INVENTION. VIRGINIA MILITARY INSTITUTE Lexington, VA
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1 RECORD OF INVENTION VIRGINIA MILITARY INSTITUTE Lexington, VA VMI Docket. FOR OFFICE USE ONLY This Record of Invention is an important legal document. Proper care in its early and complete preparation will save important time and inconvenience in the future. 1. TITLE OF INVENTION 2. GENERAL DESCRIPTION OF INVENTION. If pertinent, attach illustrations and refer to them in the description. Please address the following issues: i. What is the problem to be solved? ii. What are the disadvantages or shortcomings of previous attempts to solve the problem? iii. How does the invention work? iv. Give a detailed description of the invention. v. What further development remains to be accomplished? If more space is needed, attach a sheet. 4. NOVEL FEATURES. What distinguishes the components, steps or arrangement of your method, apparatus, article or composition from those previously known, as far as you are aware? REVISED 5/14/07 1
2 5. NON-CONFIDENTIAL SUMMARY. Please provide a non-confidential summary of your invention. This summary should be approximately one to three paragraphs in length. It should not contain any proprietary information. It should describe the advantages of your invention as related to prior technology, if any, e.g., faster, cheaper, stronger. 6. Date and place Invention was first conceived? 7. Date and place of first sketch, drawing or photo 8. Date, place and identification of first written description 9. DISCLOSURE OF INVENTION TO OTHERS Date and Place of Disclosure Form of Disclosure Was Signature Obtained? 10. Date and place of completion of first sample, operating model or full-sized device 11. Date and place of first test 12. Extent of use past, present and contemplated 13. Related or referenced publications, patents or patent applications (please attach copies of relevant research articles or other referenced publications): a. b. c. 16. Is publication of details of this invention contemplated? If yes, in what form and when? REVISED 5/14/07 2
3 17. What Institute resources, if any, were used in the creation of this invention (e.g. laboratories, equipment, funding, etc.)? 18. Was the invention made during the course of work sponsored by an organization other than VMI? If so, identify the sponsor 19. Sketch illustrating the invention (if applicable). Use separate sheet, if necessary. REVISED 5/14/07 3
4 20. PREPARER OF RECORD OF INVENTION 21. CONTRIBUTING COLLABORATORS Identify your collaborators and describe their contribution to the conception or experimental development of the invention (attach additional sheets if necessary) REVISED 5/14/07 4
5 22. ACKNOWLEDGMENT OF INSTITUTE OWNERSHIP I (We) certify that the statements herein are correct, to the best of my (our) knowledge and belief. I (We), the undersigned, as the originator(s) of this Record of Invention do hereby acknowledge that the VIRGINIA MILITARY INSTITUTE (hereinafter referred to as the "INSTITUTE"), is the owner of all rights, title and interest in and to the Intellectual Property, including any and all copyrights, patents, reissues and extensions thereof. The INSTITUTE also is the owner of all rights, title and interest in any INVENTION even if such invention is not patentable. I (We) agree that I(we) will execute all necessary assignments as requested by the INSTITUTE, its successors and assigns, to facilitate the filing of patent applications and/or copyright registrations. I (We) will render any assistance that is requested to aid in the preparation of such applications. We understand that the INSTITUTE may assign its rights, title and interest in and to the INTELLECTUAL PROPERTY. Prior to the execution of this Acknowledgment, we have not granted the right or license to make, use, or sell said INTELLECTUAL PROPERTY to anyone except the INSTITUTE, nor have we otherwise encumbered our rights, title, and interest in said INTELLECTUAL PROPERTY, nor will we execute any instrument in conflict with this Acknowledgment. IN WITNESS WHEREOF, I (we) have affixed my (our) signature(s): Date Preparer: Witness: Approved by Department Head: REVISED 5/14/07 5
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