Intellectual Property Policy APPENDIX A: Intellectual Property Disclosure Form ============================================================ 1. This form is issued in accordance with the Victoria University Intellectual Property (IP) Policy. 2. It is to be sent to the Administration Manager, Viclink Ltd, PO Box 1762, Wellington, viclink@viclink.co.nz. Viclink is required to consider: - Whether the intellectual property notified hereby is potentially commercially valuable; - Whether the University should assert its ownership of the IP, share ownership with the creator(s), or assign ownership to the creator(s); - Whether ownership of such IP should be assigned to Viclink for commercialisation; and - Whether the IP can be disclosed. 3. Viclink will make a decision within 60 working days. ============================================================ Project Summary Title Inventor (s) Department Contact Details Email: Phone: Other Contributing Inventors IP Disclosure Form Filling out the IP disclosure form below is the first stage in protecting your IP, but of itself it does not afford any IP protection. The form is intended to give all relevant information about your IP to Viclink so they can discuss with you how to best protect and commercialise it. Please provide as much relevant detail as you have. Confidentiality If your IP is maintained as confidential we can get additional or broader protection on new protectable IP produced as your technology is developed. Therefore, it is best that there are no publications concerning your IP and no discussions with third parties except under a confidentiality agreement. If you have plans for publication or discussions with commercial partners, please let us know and we can work out how that will affect IP protection. Viclink can also provide support and confidentiality agreements for discussions with third parties if needed. If you have any questions about what constitutes disclosure, please contact us to discuss. Please provide the following details. The form below is editable, so you may cut and paste text from another source (e.g. an article) if appropriate. © Victoria University of Wellington Page 1 18 July 2013 Intellectual Property Policy IP details Title What do you call your IP? Summary of IP (three paragraphs or less) Please provide an overview of your IP in plain English. (Details are sought below). What is the advantage of your IP over currently available research and products? Is it cheaper, higher quality, more efficient, higher performing, easier to operate, less steps in method, etc? Which competing products or technologies would you consider to be the closest to your IP? Please provide details. Who would you consider to be other companies/research groups operating in this area? Please provide full names of companies or research institutes. Please provide details of your IP: How it works, how it is made, operating parameters and requirements. Please include diagrams and pictures if possible and enough information for another researcher to re-create your IP if they had these details. Please provide details. If necessary, please provide attachments. Future plans for your IP: Do you have ongoing research funding for the further development of this IP? If yes, please provide details. Do you have a commercial partner for this research? © Victoria University of Wellington Page 2 18 July 2013 Intellectual Property Policy If yes, please provide details. Do you have students or post-docs working on this research currently? If yes, please provide details. Is the IP part of ongoing research or is the project finished? Please provide details. Does it require further investigation to determine how it works or tests/trials to define the outer parameters or best conditions for it to work? If yes, please provide details. Searches Have you completed any patent searches to date? If yes, please provide (or attach) details of the search and results. Have you completed any searches of the published literature? If yes, please provide (or attach) any relevant references. Have you completed any market searches to date? If yes, please provide (or attach) details of relevant technologies and comment on key similarities and differences compared to your IP. Disclosure Has the IP been published? Or publically discussed? If yes, please provide details. Are there any confidentiality agreements/non-disclosure agreements in place around © Victoria University of Wellington Page 3 18 July 2013 Intellectual Property Policy this IP? If yes, please provide details on third parties involved. Collaboration Have there been other organisations involved in the development or funding of this project? If yes, please provide details. Has this project used anyone else’s knowledge, products, processes or protected intellectual property? If yes, please provide details. Are there any external contributing inventors? If yes, please provide details. Are there any other parties that could claim ownership of this IP? If yes, please provide details. © Victoria University of Wellington Page 4 18 July 2013