TTC USE ONLY
TAMUS #
______________
DISCLOSURE OF SOFTWARE
This form is used to disclose new software for assessment and possible commercialization
and to meet obligations of disclosure as required under TAMUS Policy 17.01. Before
completing this form, please refer to the guidelines at the end of this document. Please send
your completed form, Author data sheet(s), and any additional documentation to Texas A&M
System Technology Commercialization (TTC) at disclosures@tamus.edu.
1. Name of Software:
2. Lead Author:
3. Other TAMUS Author(s):
1.
2.
3.
4.
5.
4. Other Non-TAMUS Author(s):
1.
2.
3.
5. Please identify any TTC personnel you have discussed this software with prior to disclosure (if
applicable).
6. Briefly describe the software and its current level of development.
7. Describe the closest known software or methods that perform functions similar to the disclosed
software and indicate differences.
8. Please provide the following information about the features:
a) State the advantages of the disclosed software over existing methods, problems solved by
the software, and new applications achieved.
b) Identify features that are believed to be new, unexpected, or critical.
c) Indicate any disadvantages or limitations and explain how they might be overcome.
9. Describe technical specifications of the above software (i.e. hardware requirements, third-party
programs required, programming language, etc.).
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DISCLOSURE OF SOFTWARE
10. Do you have copies (or access to copies) of any licenses required of third-party programs used in the
development of the disclosed software? These may be needed in the course of the TTC assessment.
YES
NO
NOT SURE
11. Briefly describe the level of support provided with this software:
a) Is there a manual or list of instructions?
YES
NO
b) What level of user support is required?
12. If possible, describe potential users of the software as well as any information on promotion,
marketing, or distribution that may be valuable in realizing the full potential of the software.
13. For copyright/legal purposes, please provide responses to the following:
a) Year in which creation of work was complete:
b) If the work has been published, provide the date and nation (if other than U.S.) of the first
publication. If possible, please provide copies of any formal publications for the file:
c) Has the source code been distributed in any form?
YES
NO - If “YES,” please explain.
d) If you wish to seek copyright registration for the work, please submit along with this disclosure
the following:
1. Two electronic copies of the source code, and
2. Two electronic copies of any manual or operating instructions (if available)
14. Funding: Rights in technologies may be impacted by, or obligated under, the terms of
agreements with entities that provided the funding that led to the technology’s development.
Examples of entities that provide funding under agreements include, but
are not limited to,
federal agencies, state agencies, non-profit research foundations, commodity boards, private
companies, industry associations/organizations, and providers of gift contributions.
a) If no funding provided under a funding agreement was used to develop this invention,
please indicate so by checking this box
and proceed to question 14. Otherwise, proceed
to question 13.b.
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DISCLOSURE OF SOFTWARE
b) Please list all sources of funding used in the conception and development of the disclosed
technology/discovery; include grant numbers or other unique, assigned identifiers for each.
Name of Funding
Agency/Entity
Federal Grant /
Agreement
/ Contract / or Other
Type of Award No.
Internal Acct. No. or
Other Type of Internal
Reference No.
Contracts & Grants
Office managing award
(e.g. AgriLife, TAMU,
TAMRF, TEES, etc.)
15. If work on the software is to be continued, indicate the source(s) of funding and the nature of the
work.
16. Identify SYSTEM component that provided the facilities or services under which the software was
conceived and developed.
17. Indicate if the software was made as part of one’s assigned duties within the SYSTEM component.
18. Commercial Entities. Please provide information about commercial entities that may be interested in
this software and describe your discussion(s) or contact(s) with them regarding this software (if
applicable). Please provide contact information (name, phone/email.)
a) Companies with which you have discussed this software:
b) Companies that you have contacted regarding this software.
c) Companies that you would recommend to be contacted regarding this software.
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DISCLOSURE OF SOFTWARE
AUTHOR DATA SHEET
Please complete an Author Data Sheet for each named Author including non-TAMUS Authors. Additional
Author Data Sheets may be found at http://techtransfer.tamus.edu.
Contribution:
Briefly describe your contribution to the disclosed software.
Author:
First:
MI:
Last:
Preferred Salutation: Professor
PhD
DVM
MD
Dr.
MS/MA
Ms.
Mrs.
BS/BA
Mr.
Other
Other:
Please name any joint appointments and/or affiliation that you have with another institution,
including but not limited to joint appointments within TAMUS (if any):
University ID Number (UIN):
Country of Citizenship:
Work Address:
Home Address:
street address
street address
city/state/zip
city/state/zip
phone
phone
fax
fax
work email
home email
TAMU System Employment Status/Title (including former employees):
Professor
Associate Professor
Assistant Professor
Employed Student
Other Status/Title (if not listed above):
Former Texas A&M University System Employee
If you checked “Former Texas A&M University System Employee,” were you employed by the
A&M System at the time of technology or discovery?
YES
NO
System Component: (AgriLife, TAMU, TEES, TTI, Kingsville, Corpus Christi, etc.):
Department/Division:
Laboratory or Center:
Non-TAMU System Employment Status/Title (for non-System Authors only):
Please provide your Position/Title and Company Name:
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DISCLOSURE OF SOFTWARE
SIGNATURE PAGE
Each named Author must sign and date this page; non-TAMUS Author signatures are optional, but
still must be named on this page. Please also indicate each Author’s percentage of contribution to
the disclosed software.
Title of Software:
Author Signature(s):
I/We certify that the information in this Disclosure of Software is complete and accurate.
Printed Name:
% contribution
Date
Printed Name:
% Contribution
Date
Printed Name:
% Contribution
Date
Printed Name:
% Contribution
Date
Printed Name:
% Contribution
Date
% Contribution
Date
Printed Name:
Witness Signature (optional):
Disclosed to and understood by me this
day of "MONTH", "YEAR".
Witness Printed Name:
Please submit this completed form including all Author Data Sheet(s) and the signed Signature Page
to disclosures@tamus.edu or mail to
Texas A&M System Technology Commercialization / Attn: Disclosure of Technology
3369 TAMU / College Station, TX 77843-3369
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DISCLOSURE OF SOFTWARE
GUIDELINES
You may contact Texas A&M System Technology Commercialization for a consultation prior to
submitting your disclosure. Please contact us at 979-847-8682 or visit our website at
http://techtransfer.tamus.edu.
1. If you have never submitted a disclosure of software before, it is recommended that you
contact Texas A&M System Technology Commercialization to arrange a consultation.
2. If you are disclosing a plant variety or plant germplasm, or invention, please use the Plant
Variety/Germplasm Disclosure Form or Disclosure of Invention Form as appropriate. These
forms are available at the TTC website.
3. Please be advised that your disclosure will be assessed on the basis of how it could enable
a commercial opportunity. If you would like to discuss commercial applications of your
disclosure, please contact the TTC for a consultation.
4. In the event that your disclosure is accepted, it will become the subject of a
commercialization plan, with the goal of achieving a licensing agreement with a company
that will commercialize the software. In the event that your proposal is not accepted, you
will be informed and may elect to request a release of TAMUS rights in the disclosure such
as it has been disclosed.
5. All questions must be answered and all Author data sheets must be submitted. If any
question is not answered or if there are missing Author data sheets, the disclosure will be
returned for completion.
6. If you have supporting documentation that will further clarify the nature of the disclosure
and/or the commercial opportunity, you may submit these along with the completed form
and Author data sheet(s).
7. After submitting your disclosure, and after verifying that the form is complete, the form
will be sent out for export controls review to determine whether the disclosure contains
materials which are subject to export control regulations. When your disclosure is
returned to the TTC, the disclosure will be assigned to a project manager and you will be
notified.
8. As per TAMUS Policy 17.01, the TTC will make a decision regarding your disclosure within
ninety (90) days. Since the assessment process is interactive, you can accelerate this
process by meeting with the assigned project manager as soon as possible.
Form Revised 07/18/2013