Fillable Intellectual Protection And Patent Sign-Off Form printable pdf download

SUBMIT FORM TO:

etdsvcs@utoledo.edu

(digital signatures accepted) OR RETURN TO:

College of Graduate Studies

Main Campus

Health Science Campus

University Hall Room 3240

Mulford Library Room 113

Mail Stop 933

Mail Stop 1042

Intellectual Protection and Patent Sign-Off Form

The Intellectual Protection and Patent Sign-Off Form is designed to ensure that any invention contained in the

thesis or dissertation and presentation/defense of the paper is legally protected. Completing this form ensures

that access to the document or presentation/defense, which might disclose an invention, is determined at the

direction of the student and faculty advisor. Upon public disclosure of an invention all international patent rights

are lost and a one-year bar date is set to file a patent in the U.S. or all rights are lost.

For assistance in determining if it is appropriate

Mark W. Fox, M.S., J.D.

to request an access delay, or a closed

Office of Research Development

presentation or defense, please contact

419.383.6907 (office phone)

the UT Patent Technology Associate:

mark.fox@utoledo.edu

Information about the technology transfer process is available at

Instructions: This form must accompany the Acceptance of Thesis or Dissertation for Defense form and be

submitted no later than fifteen (15) business days prior your scheduled defense date. Failure to submit this

document could prevent or significantly delay the awarding of the degree. Electronic submission encouraged.

Student’s Name: _______________________________________ Rocket ID: _____________________

Advisor: ______________________________________________________________________________

Title of Research: _______________________________________________________________________

_______________________________________________________________________________________

I. Patent Protection for this University of Toledo Thesis or Dissertation.

Please choose one:



We have reviewed this document and presentation/defense for any potentially patentable new creation,

discovery, or invention and have determined that it does not warrant patent protection.



We have submitted an Invention Disclosure Form to the University of Toledo’s Office of Research

Development for review by the Patent Commercialization Committee.

II. Defense of Dissertation or Master’s Thesis.

If the defense or presentation will include any proprietary or potentially patentable subject matter, it

should not be open to the public and should not be advertised as such.

Please choose one:



The presentation/defense of the above titled thesis/dissertation WILL NOT include proprietary or

potentially patentable subject matter and should be open to the public.

Intellectual Protection

Revised 2/2016

Page 1 of 2

Intellectual Protection And Patent Sign-Off Form

Related Articles

Related forms

Related Categories