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APPENDIX 2.3Sample Invention Disclosure Form
Tom BrandW. P. Thompson & Co.
Inventor(s)................................................................................................................
Invention conception date (ICD) (when was the invention conceived?)................(dd/mm/yy or mm/yy)
Has the invention been reduced to practice (shown to work in practice)?
� Yes � No
If applicable, on what date was the invention reduced to practice?.......................(dd/mm/yy or mm/yy)
At invention conception date, were all inventors employed by Company X?
� Yes � No
If applicable, provide on a separate sheet employment details at the ICD for allinventors not employed by Company X at that date.
Invention Title..........................................................................................................
Invention Disclosure
Provide as an attached document full details of the invention, including the followingkey points:
Relevant prior art—indicate those documents and describe any current practices thatrelate most closely to the field of the invention.
Problems—indicate what the prior art fails to achieve, where the prior art falls short,and how this is relevant to the invention.
Novel features—describe the novel features of the invention, in other words, thosefeatures (or combination of features) that are not known in the prior art.
From Innovation to Cash Flows: Value Creation by Structuring High Technology AlliancesCopyright C© 2009 by Constance Lutolf-Carroll with the collaboration of Antti Pirnes. All rights reserved.
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2 APPENDIX 2.3: SAMPLE INVENTION DISCLOSURE FORM
Advantages—describe how the invention achieves a technical advantage over theprior art.
Proof of principle—describe in detail any technical or experimental details thatdemonstrate the invention working in practice or the feasibility of its so doing.Include any diagrams, figures, graphs, or tables that illustrate the invention.
Commercial Prospects..............................................................................................
(How do you envisage the invention being exploited by Company X, and, in par-ticular how will Company X generate revenue, or derive competitive advantage, byprotecting the invention?)
DeclarationI have read the contents of this Invention Disclosure Record and the attached docu-ment and request that it be submitted to and considered by the relevant managementof Company X.
............................................................ ................Signature(s) Date
The purpose of the invention disclosure is to provide a record of the invention, andenough information to commence a patent filing. The key points are:1. Identification of inventor and confirmation of employment status.2. Date of invention, both conception and reduction to practice.3. Full description of invention, including reference to closest prior art and iden-
tification of the problems addressed by the invention and the solutions therebyafforded.
