VCOM Institutional Policy and Procedure Manual

Intellectual Property Disclosure

Documentation of Invention and Public Disclosure When was the invention first conceived (approximate date)? List any documentation of invention: Lab notebooks Computer files No documentation other than this Invention Disclosure Form

Photographs, charts, other visuals

Correspondence

Other:

Earliest date of documentation: Is all documentation currently in the possession of the lead originator/inventor or contributor inventor? Yes No If No, please explain: Date of first publication or oral disclosure (electronic, print, thesis, or other media): If unpublished and undisclosed (including a thesis on hold), provide the anticipated disclosure date and any submissions already made for publication: Date of anticipated disclosure: Any submissions for publication? If yes, date submitted:

CONFIDENTIAL

VCOM

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