Intellectual Property Notification Form ============================================================== 1. This form is issued in accordance with the Victoria University IP Policy. 2. It is to be sent to Victoria Link’s IP Committee (VLLIPC). This Committee 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, Whether the IP can be disclosed. 3. The VLLIPC will make a decision within 60 working days. ============================================================== A. Title and Description of the IP (Please include technical description, purpose, state of development, commercial applications) B. How was the creation of the IP funded? School Funds Research Grant External Sponsor Other (Please give details) C. Who Created the IP? Name: % contribution: Name: % contribution: Etc Have the % contributions been agreed to among the creators? If so, please append signatures here: © Victoria University of Wellington Page 1 Last approved 25 May 2009 Intellectual Property Policy Research Policy D. Was the work commissioned by Victoria University? (Please give details) E. What ongoing Victoria University space, resources, funding, people etc. will be needed to further develop and/or commercialise the IP? F. Do any external parties have an interest in this IP? (Please give details) G. Has the IP been disclosed? (Please give details) Signed: Project Leader: __________________________________________Date_____________ University Manager: __________________________________________Date_____________ © Victoria University of Wellington Page 2 Last approved 25 May 2009 Intellectual Property Policy Research Policy VLLIPC Decision Commissioned by VUW: action to be taken by commissioning entity Not commercially promising: negotiate assignment of IP to Creator(s) Commercially promising but exclusivity not important: share IP with Creator(s) Commercially promising and exclusivity is important: assign IP to Viclink Unsure: do more work and resubmit Disclosure: permitted / not permitted / postpone until further notice Other: Signed: ___________________________________________Chair VLLIPC Date____________________ © Victoria University of Wellington Page 3 Last approved 25 May 2009