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NOTE: This form is not intended as legal advice.  Nor is it a solicitation for engagement.  Rather, this
form is supplied as a convenience for those seeking legal assistance from any patent attorney.

INVENTION DISCLOSURE FORM FOR UTILITY PATENT APPLICATION

Instructions: Provide the following information and promptly confer with your attorney

to develop a proper course of action. 

Descriptive Title:_____________________________________________________
Inventor: __________________________ Tel/Fax/Email ______________________
Address: __________________________________________ Citizenship: _______
(Include same information for co-inventors if applicable)
Employer: __________________________________________________________
Address: ___________________________________________________________

1. What is the problem solved by the invention?______________________________
__________________________________________________________________
__________________________________________________________________

2. How was the problem solved before the invention?_________________________
__________________________________________________________________
__________________________________________________________________

3. Describe the invention - list and/or attach all relevant information (e.g., specifications
and drawings): ______________________________________________________
__________________________________________________________________
__________________________________________________________________

Utility - What does the invention do? ______________________________________
__________________________________________________________________
__________________________________________________________________

Method - What functional steps does the invention perform? ____________________
__________________________________________________________________
__________________________________________________________________

Novel Features - What are the features of the invention that distinguish it from other

known solutions to the problem being solved? _______________________________
__________________________________________________________________
__________________________________________________________________

Benefits - What positive or unexpected results are provided by the invention: __________________________________________________________________
__________________________________________________________________
__________________________________________________________________

4. The invention was first conceived on (date)_______________________________

5. A prototype was completed and demonstrated on (date)_____________________

6. The invention was first published or otherwise disclosed on (date) _____________
    (describe nature of disclosure) ________________________________________
__________________________________________________________________
__________________________________________________________________

7. The invention was first sold or offered for sale on (date)______________________
    (describe nature of sale or offer for sale) _________________________________
__________________________________________________________________
__________________________________________________________________

Additional Patent Information:

 

   

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