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New Invention Report (CONFIDENTIAL)

Report Date

:_____________________

Report By

:________________________________ (contact name; telephone number)

Title of the Invention

(3-10 words) ________________________________________________

Project/Product Name

_____________________________________ _____________________________________

Instructions: Fill in this form to the best of your ability, starting with the above box. Submit thecompleted form by email or hardcopy directly to ________________________________________.

1.SUMMARY OF THE INVENTION:

Give a brief summary of the invention and what it does.

_____________________________________________________________________________________ _____________________________________________________________________________________

2.BACKGROUND OF THE INVENTION:

What problems does the invention solve? If you know of any prior approaches to these or similar problems, please describe them. Why were those prior approaches inadequate? If youknow of any patents, articles, publications, conferences, seminars, or products (our's or competing), which attempted to address these or similar problems (or which may be otherwiserelevant to the invention), please identify them. Attach additional pages, as necessary.

2.DESCRIPTION OF THE INVENTION:

Describe** in detail the “best” implementation (usually, the latest version) of the invention withreference to illustrative figures or diagrams. Also describe any product line or prior products/concepts into which it can be incorporated, and alternate ways of implementing it, if any. Describe not only the invention’s functional components( or process steps), but also howthey operate. For example, Attach additional pages, as necessary.** NOTE: If an existing document provides the required information, please simply attach it tothis report. There is no need to restate the content, though you may need to augment it for thisreport.

_____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________

3.ADVANTAGES OF THE INVENTION:

Describe any technical benefits or competitive advantages provided by the invention. What aspects of the invention do you regard as clever or novel? This is your chance to “sell” theinvention.

4.Important Information

a)About when was the invention conceived? ________________ b)Was the invention ever disclosed to another company? Yes____ No____ If so, when? ________________ Who was it disclosed to? ___________________ Was there an NDA in place? Yes____ No____ If not yet disclosed, when will such disclosure first take place. ________________ c) Has/Will the invention been incorporated in a product? Yes___ No____ Product Name: ________________ Has this product been offered for sale or publicly used? Yes___ No___ Don’t know ___ If so, when? ______________ If you don’t know, who would? __________________ d) If the invention is a process, has it been used commercially? Yes____ No____ If so, when did such use start: ________________ If you don’t know, who would? __________________ e) Is the invention scheduled for publication in any journal or for presentation at any conference or tradeshow? Yes____ No____ If so, when: ________________ If you don’t know, who would? ___________________

6.INVENTORS:

Provide the following information for each person who “materially contributed” to theinvention.

If there are more than two inventors, please provide information for each.

1) First Inventor's Name:____________________ email:_______________ Post Office Address:____________________________________________ Home phone: ________________ Residence (if different):___________________________ Work phone ________________ Country of Citizenship:_____________ 2) Second Inventor's Name: ___________________email:_______________ Post Office Address:____________________________________________ Home phone: _________________ Residence (if different):________________________Work phone: _________________ Country of Citizenship:_______________________ 3) Third Inventor's Name: ___________________email:_______________ Post Office Address:____________________________________________ Home phone: _________________ 3