Invention Disclosure Report Form
Royal Holloway Invention Disclosure Report Form
Note that information supplied will be used to help determine whether the College should invest in a
patent for your invention. Please complete the form as far as possible. If some details are not
immediately available please indicate when they can be expected.
Case Number
Department/s
Title of Invention
Please take time to answer the following questions:
1. Funding context
Please state the name of the funding partner that sponsored the research leading to the invention. If
none state ‘none’.
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2. List all inventors’ names and permanent addresses including post codes
(Note - it is very important that all inventors are named and that only those who are inventors are
named – failure to do either of these can be a ground for invalidity)
[Note – home addresses and postal codes are required for patent agent records, but you may elect not
to have your home address published on the patent specification, in which case Royal Holloway’s
address will be used]
A ………………………..
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C ………………………..
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B ………………………..
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D ………………………..
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3. Names of all inventors who were not employed by Royal Holloway at the time
the invention was made
(eg students, academics employed by other institutions, visiting academics, an inventor who invented
partly in a position with a previous employer and partly in employment with Royal Holloway)
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Send: Afua Osei, Contracts & Intellectual Property Manager (afua.osei@rhul.ac.uk)
Invention Disclosure Report Form
4. Respective contributions of inventors expressed as a fraction
(Note – in the event of commercial returns this information will be used to determine the share of
income to each inventor)
5. Has this invention been disclosed or made available to any person other than
employees of Royal Holloway in any form whether written, orally, at a
conference, or on the web?
(Note – any disclosures not covered by a confidentiality agreement may destroy the novelty in the
patent and make it invalid.)
YES / NO
6. Description of Invention:
A) Brief Summary:
What technical problem does the invention overcome?
B) Background/ Improvement over prior art (including specific literary citations)
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Send: Afua Osei, Contracts & Intellectual Property Manager (afua.osei@rhul.ac.uk)
Invention Disclosure Report Form
Detailed Description (add extra pages and sketches or drawings, if necessary, as well
as any relevant manuscripts or articles):
7. Expected future uses and/or commercial applications (please list as many
applications as you feel feasible):
8. All Inventors sign below.
(In signing the form you each hereby certify that to the best of your knowledge all information
provided in this document is accurate and true)
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Send: Afua Osei, Contracts & Intellectual Property Manager (afua.osei@rhul.ac.uk)