Comprehensive Invention Disclosure & Technology Commercialization Form

1. Section 1: Lead Inventor & Grant Sponsor Metadata - Establishing Inventorship and Funding Provenance

This section captures essential information about the inventors and the funding sources that supported the development of the disclosed technology. Accurate metadata is critical for determining ownership rights, compliance obligations, and royalty distributions under institutional intellectual property policies and applicable research funding agreements.


Lead Inventor Full Legal Name

Lead Inventor Academic Title/Position

Lead Inventor Primary Department/Division

Lead Inventor Institutional Email Address

Lead Inventor Direct Phone Number

Lead Inventor Employee/Staff ID Number

Are there additional co-inventors who contributed to the conception and reduction to practice of this invention?


Grant Sponsor Metadata - List all grants that funded the research leading to this invention

Funding Agency/Organization Name

Grant/Contract Number

Grant Start Date

Grant End Date

Total Award Amount

Grant Program Officer Name

Grant Officer Contact Email

Percentage of Total Research Time on This Grant

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Select all funding source categories that apply to this invention's development

What percentage of the total development effort was funded by federal sources?

Did any inventors receive funding, materials, or resources from external entities not listed above (e.g., visiting scholar support, equipment loans)?


Do any inventors have existing consulting agreements, equity positions, or financial interests with companies that could potentially license this technology?


2. Section 2: Technology Description & Commercial Utility Summary - Defining the Invention and Its Market Potential

Provide a comprehensive technical description and commercial assessment of your invention. This information forms the foundation for patent drafting, prior art searches, and commercialization strategy. Be thorough in describing the problem, solution, and market opportunity to enable effective evaluation by technology transfer professionals and patent counsel.


Executive Summary of the Invention

Detailed Technical Description of the Invention

Specific Problem or Need Addressed by This Technology

Key Advantages and Benefits Over Existing Solutions

Primary Technology Category (select all that apply)

Potential Applications and End-Use Markets

Current Technology Readiness Level (TRL) - Rate from 1 (basic principles observed) to 9 (system proven in operational environment)

Experimental Data, Prototypes, or Proof-of-Concept Results

Is a functional prototype or working model available for demonstration?


What is your preferred commercialization pathway?

Rate the following aspects of the invention's commercial potential

Very Low

Low

Moderate

High

Very High

Market size and growth potential

Competitive advantage sustainability

Technical feasibility and risk

Regulatory pathway complexity

Time to market

Scalability of manufacturing

Alignment with institutional priorities

Known Competitors or Similar Technologies

Upload Supporting Technical Documents (lab notebooks, manuscripts, data sets, CAD drawings, software code repositories)

Choose a file or drop it here
 

3. Section 3: Federal Funding & Bayh-Dole Act Compliance Check - Ensuring Statutory Obligations and Government Rights

This section addresses compliance with the Bayh-Dole Act (or equivalent legislation) governing inventions made with federal funding. Accurate disclosure ensures proper electing of title, compliance with reporting requirements, and understanding of government rights. Failure to comply can result in loss of patent rights and institutional liability.


Was any portion of the research leading to this invention funded by a federal government agency?


Percentage of invention development directly attributable to federal funding (if applicable)

Has the invention been formally reported to the relevant federal funding agency within the required two-month period after disclosure to the institution?


I acknowledge and confirm understanding of the following Bayh-Dole Act requirements (check all to confirm)

Assess compliance status for each Bayh-Dole obligation

Non-Compliant

Partially Compliant

Compliant

Not Applicable

Invention disclosure to institution within required timeframe

Institutional election of title within statutory period

Patent application filing within one year (or extended period)

Government support acknowledgment in patent applications

Preference for US industry/manufacturing

Compliance with march-in rights provisions

Maintenance of proper laboratory records

Does the invention involve national security, sensitive technology, or export-controlled subject matter?


Describe any existing or planned collaborations with foreign institutions, researchers, or companies regarding this technology

Government Rights and License Summary

Funding Agency

Grant Number

Government License Required?

License Type/Scope

Invention Report Date to Agency

Patent Application Filing Deadline

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Has the institution received any formal march-in rights notices or government inquiries regarding this or related technology?

4. Section 4: Prior Public Disclosures & Patentability Search Results - Preserving Patent Rights Through Disclosure Management

Complete disclosure of all prior public disclosures is critical for patentability assessment. Under patent law, public disclosures can trigger statutory bars and destroy novelty. This section enables technology transfer offices and patent counsel to evaluate grace period applicability, design around strategies, and assess the strength of potential patent claims. Include all forms of disclosure regardless of perceived significance.


Have you publicly disclosed the invention in any form before the earliest conception date recorded?


Has a formal patentability or prior art search been conducted for this invention?


List any known patents, patent applications, or publications that you believe may be relevant prior art

Has the invention been discussed with any external companies or potential commercial partners under a confidentiality agreement?


Are there any third-party materials, background IP, or jointly-owned technology incorporated into this invention?


Has there been any offer for sale, commercial use, or revenue generation using this technology?


What is the earliest date you consider the invention to have been conceived?

What is the earliest date you consider the invention to have been reduced to practice (e.g., working prototype, successful experiment)?

Describe any internal laboratory notebooks, electronic records, or other documentation that establish conception and reduction to practice dates

5. Section 5: Tech Transfer Office & University Legal Counsel Sign-Off - Institutional Review and IP Management Approval

This final section documents institutional review, risk assessment, and formal acceptance of the invention disclosure by authorized technology transfer and legal personnel. This formal sign-off triggers the intellectual property protection workflow, commercialization strategy development, and establishes the official record of institutional ownership and management responsibilities.


Primary Technology Transfer Office Case Manager Assigned

Date of Disclosure Submission to TTO

Has a formal intellectual property assignment agreement been executed by all inventors?


Institutional Ownership Determination

Technology Transfer Office Risk Assessment and Viability Matrix

Poor

Fair

Good

Excellent

Outstanding

Patentability prospects

Commercial potential

Market readiness

Regulatory pathway clarity

Competitive landscape intensity

Freedom to operate risk

Inventor commitment to commercialization

Alignment with institutional mission

Has university legal counsel reviewed this disclosure for contractual and legal compliance?


Does this invention require specialized legal review (e.g., export control, FDA regulatory, data privacy)?


Action Items and Next Steps - TTO to Complete

Action Item

Responsible Party

Target Completion Date

Priority (1=Low, 5=Critical)

Completed?

Initial prior art search
TTO Patent Coordinator
2/15/2025
 
 
Inventor interviews for patent drafting
External Patent Counsel
3/1/2025
 
 
Market analysis and licensing strategy
TTO Licensing Manager
3/15/2025
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Are all inventors committed to actively participating in the commercialization process (e.g., responding to patent counsel, attending marketing meetings, supporting licensee discussions)?


TTO Internal Notes and Commercialization Strategy Recommendations

Lead Inventor Signature - Certifying accuracy and completeness of disclosure

Technology Transfer Office Director Signature - Accepting disclosure for institutional IP management

University Legal Counsel Signature - Confirming legal review and risk assessment

Why settle for ‘good enough’ when you can make this form legendary? Click edit and let’s level it up! 🚀 Edit this Invention Disclosure Form for Academic Technology Commercialization
Don't see what you're looking for? With Zapof, you can create forms just like this one, designed precisely for your needs.
This form is protected by Google reCAPTCHA. Privacy - Terms.
 
Built using Zapof