This section establishes the inventor's identity, employment context, and project provenance. Accurate completion ensures proper ownership determination and compliance with employment agreements. All fields marked mandatory are required for form submission.
Employee ID Number
Full Legal Name
Official Job Title
Primary Department/Division
Direct Manager Name
Employee Corporate Email
Original Hire Date with Current Employer
Primary Work Location (City, Country)
Is this invention a joint creation with other employees?
Project Name or Code
Project Initiation Date
Date of Invention Conception (First Idea)
Date of Reduction to Practice (Working Prototype/Demo)
Was this project formally assigned to you by management?
Estimated Percentage of Work Time Dedicated to This Invention (%)
Which company resources were utilized in developing this invention? (Select all that apply)
Company-issued laptop/workstation
Company network/servers
Company software licenses
Company laboratory equipment
Company proprietary data
Internal R&D budget
Company facilities/workspace
None - developed entirely on personal time with personal resources
Were you specifically hired to research or develop in this technical domain?
Primary Funding Source for This Project
Internal R&D operating budget
Specific client/customer contract
Government research grant
Corporate venture funding
Personal initiative without formal funding
Other
Does this invention relate to a specific customer deliverable or contract?
Provide comprehensive technical details to enable patentability assessment and strategic IP protection decisions. Include sufficient information for prior art search and patent claim drafting. Attach supporting documentation where available.
Proposed Invention Title
Invention Category
Software/Algorithm
Hardware/Apparatus
Manufacturing Process
Business Method
Chemical Composition
Biotechnological
Design
System/Architecture
Other
Technical Field and Background Context
Specific Technical Problem Addressed
Detailed Technical Description of the Invention
Attach Technical Drawings, Architecture Diagrams, Flowcharts, or Schematics
Key Novel Features and Innovative Aspects
Rate the invention's characteristics across the following dimensions
Very Low | Low | Moderate | High | Very High | |
|---|---|---|---|---|---|
Technical complexity and sophistication | |||||
Potential for industry disruption | |||||
Ease of implementation/integration | |||||
Scalability potential | |||||
Robustness and reliability |
Current Development Stage
Concept/Idea only
Proof of concept developed
Functional prototype exists
Tested and validated
Production-ready implementation
Commercially deployed
Is a working prototype or demonstration available?
Have you conducted formal testing or validation?
Potential Commercial Applications (Select all relevant)
Internal process improvement
New product line
Feature enhancement
Cost reduction
Performance optimization
Licensing revenue
Defensive blocking
Open source release
Other
Estimated Commercial Value Potential (1 = Minimal, 5 = Transformative)
Estimated Annual Economic Value (if quantifiable)
Invention Development Timeline - Key Milestones
Milestone Date | Milestone Description | Evidence/Documentation Reference | Supporting Evidence | |
|---|---|---|---|---|
1/15/2025 | Initial concept documented | Lab notebook entry LN-2025-0115 | ||
2/20/2025 | First prototype completed | Git commit hash a3f9c2d | ||
Full disclosure of prior inventions, third-party materials, and public disclosures is critical to avoid ownership disputes, license compliance issues, and patent invalidity risks. Withholding information may jeopardize patent rights and create legal liability.
Have you conceived any inventions prior to your current employment that relate to this disclosure?
Does this invention incorporate or improve upon existing company technology?
Third-Party Materials Incorporated (Select ALL that apply)
Open source software/libraries
Commercially licensed software
Public domain code
Academic/research publications
Standards-essential patents (SEP)
Third-party proprietary code under NDA
No third-party materials used
Does any incorporated code require disclosure of derivative works or source code distribution?
Are you subject to confidentiality or IP assignment obligations from previous employers or academic institutions?
Public Disclosures Made Before This Filing (Select all that apply)
Academic paper published
Conference presentation
Public product demonstration
Social media post
Website/blog publication
Discussion with external parties without NDA
None - no public disclosure
Have you conducted a prior art search for existing patents or publications?
Are there any ongoing or threatened litigation matters related to this technology area?
This section clarifies ownership rights, inventor agreements, and strategic decisions regarding IP protection. Accurate completion is legally binding and determines the company's ability to secure patent rights and commercialize the invention.
Do you agree to assign all right, title, and interest in this invention to the company under your employment agreement?
Are any co-inventors non-employees, contractors, or from other organizations?
Inventorship and Contribution Declaration
Inventor Name | Employee ID (if applicable) | Specific Contribution to Conception and Reduction to Practice | Estimated Contribution Percentage (%) | |
|---|---|---|---|---|
Date of Current Employment Agreement Governing IP Rights
Are you aware of any agreements that might conflict with company ownership of this invention?
Your Recommendation for Patent Protection
Strongly recommend patent filing
Recommend patent filing
Neutral - defer to legal counsel
Do not recommend patent - consider trade secret
Do not recommend protection - publish defensively
Preferred IP Protection Strategy
Utility patent (invention functionality)
Design patent (ornamental design)
Trade secret protection
Defensive publication
Open source release
No action at this time
Target Jurisdictions for Patent Filing (if applicable)
United States
European Patent Office
China
Japan
South Korea
India
Brazil
Canada
Australia
Other
Do you plan to publish or present this invention publicly in the next 12 months?
Should the company impose a publication hold to preserve patent rights?
Potential Licensees or Strategic Partners Identified
Was this invention developed under any government funding, grant, or contract with special IP provisions?
This final section is reserved for executive and legal review. CTO assesses technical merit and strategic alignment. IP Counsel evaluates patentability, freedom-to-operate, and filing strategy. Both must sign off before proceeding with patent applications or other IP actions.
=== CTO REVIEW SECTION ===
CTO Technical and Strategic Assessment
Poor | Fair | Good | Excellent | Outstanding | |
|---|---|---|---|---|---|
Technical feasibility and implementation readiness | |||||
Alignment with company technology roadmap | |||||
Competitive differentiation potential | |||||
Resource requirements for further development | |||||
Strategic business value |
CTO Technical Review Comments and Development Recommendations
CTO Recommendation on Proceeding
Approve for patent filing
Approve for trade secret protection
Request additional technical due diligence
Defer - low strategic priority
Reject - not technically viable
=== LEAD IP COUNSEL REVIEW SECTION ===
IP Counsel Legal and Patentability Assessment
Very Low | Low | Moderate | High | Very High | |
|---|---|---|---|---|---|
Novelty compared to prior art | |||||
Inventive step/non-obviousness | |||||
Enablement and description sufficiency | |||||
Claim scope potential | |||||
Freedom to operate clearance |
Are there identified freedom-to-operate risks or potential infringement concerns?
Prior Art Risk Level
Low risk - clear patent path
Moderate risk - narrow claims possible
High risk - significant prior art barriers
Very high risk - likely unpatentable
Recommended Claim Scope and Patent Filing Strategy
Filing Urgency Based on Disclosure Deadlines and Competitive Landscape
Immediate - file within 30 days
High - file within 90 days
Standard - file within 6 months
Low - can wait for next filing cycle
Not urgent - no immediate deadline
Final IP Action Decision
File utility patent application
File design patent application
Maintain as trade secret
Publish defensively
Release as open source
Abandon - no protection
Further review required
Risk Assessment and Mitigation Plan
Risk Type (Ownership, FTO, License, Disclosure) | Severity (1-5) | Mitigation Actions Required | Responsible Party | Target Resolution Date | |
|---|---|---|---|---|---|
=== AUTHORIZATION SIGNATURES ===
Employee/Inventor Signature - Certifies accuracy and completeness of disclosure
Employee Signature Date/Time
Chief Technology Officer Signature - Approves technical merit and strategic fit
CTO Signature Date/Time
Lead IP Counsel Signature - Approves legal clearance and filing strategy
IP Counsel Signature Date/Time
HR Representative Signature - Confirms employment status and agreement compliance
HR Signature Date/Time
Attach Supporting Documentation Package (lab notebooks, code commits, design files, test reports, etc.)