Confidential
INNOVATION REPORT
Prepared by:
Date:
INNOVATION TITLE:

N.B If you require any assistance to complete this document please contact either
Warren Bailey (in the Enterprise Partnerships and Commercialisation team on 9805
3166, or by email at: [email protected] or your Faculty Business Development
Manager.
1.
DESCRIPTION OF THE INNOVATION
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2.
CONFIDENTIAL
CONTRIBUTORS
(Note: While only those who make bone fide inventive contributions should be named on any patent
applications, the inventor(s) may wish to acknowledge those who contributed in other ways, e.g research
management or experimental support because, at the discretion of the inventor(s)( after giving due weighting
to the actual inventive step), those other contributors may also be rewarded in accordance with University
Policy and certainly should be named as authors on publications where appropriate. If in doubt as to whether
an input is “inventive” for the purposes of the Patent Act, EPC staff can arrange for the matter to be discussed
with an independent party.)
If any inventor is a student please clearly designate as such in the “Employer” field.
Full name:
Inventive Contribution:
Employer(s) when Inventive Contribution made:
Technical / Experimental Support:
Full name:
Inventive Contribution:
Employer(s) when Inventive Contribution made:
Technical / Research Support:
Full name:
Inventive Contribution:
Employer(s) when Inventive Contribution made:
Technical / Research Support:
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CONFIDENTIAL
Distribution of Contributor Rewards
(as defined by University Policy)
Contributor
Name
Inventive
Contribution
Other
Contribution
Total
Contribution
100%
3.
OWNERSHIP
List and attach copies of any government or private agreements or grants
(including University-funded grants) under which the innovation may have been
conceived or made and discuss briefly their relationship to the innovation.
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4.
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RESEARCH PROJECT
a) Are there commercialisation objectives for this research i.e is the research
seeking to produce a commercial outcome?
b) Are all or some of the inventors interested in supporting the commercialisation
process and if so, in what manner? What steps have been taken thus far?
c) Do the inventors have a view as to the appropriate commercialisation vehicle
for the innovation e.g start-up company, licensing, joint venture?
d) What stage of the development process is the innovation at, e.g basic idea,
proof of concept, research prototype, commercial prototype?
e) When was the innovation substantially conceived and what laboratory records
have been kept to date?
f) What further research and development is required, and is funding currently
available to achieve these outcomes?
g) If further research and development is required, please attach a preliminary
R&D project plan.
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MARKETABILITY
a)
What is the problem solved by this innovation?
b)
What is the compelling need for a solution?
c)
What is the current solution(s) to this problem?
d)
Why is this innovation a better solution?
e)
CONFIDENTIAL
Would your solution be easy to copy?
f) Who is the potential customer, what is the value of the innovation to the
customer and approximately how many potential customer are there?
g) How will the customer obtain the innovation commercially?
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6.
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NOVEL FEATURES OF THE INNOVATION
Identify the feature(s) which you consider distinguishes the innovation from that
which was previously known. Explain the significance of each of these features
and how they affect the operation or results of the innovation.
Have you conducted any patent data base (e.g www.uspto.gov ) or literature
searches to test whether the above features are novel? YES/NO
If YES above please attach copies of search reports.
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7.
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DISCLOSURES
Has the innovation, or information relating to the innovation, been published,
submitted for publication or presented at a seminar or conference? If so, please
attach a copy of the relevant disclosure and provide the dates for the following:
Paper/Abstract submitted
Paper/Abstract published
Presentation took place
Has the innovation or information relating to the innovation, been disclosed to
any other party (eg. present or possible future collaborator or commercial
partner)? If so, please provide details. Was a confidentiality agreement signed?
Are any publications or presentations of the innovation planned? If so, provide
the likely dates and details of what information is to be included.
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8.
CONFIDENTIAL
ACKNOWLEDGMENTS
Inventors:
We, the undersigned, agree that we have read the contents of this invention
disclosure form and certify that:
(a)
(b)
to the best of our knowledge and belief we are the first, true and only inventors of
the invention described in clause 1 of this document, and
the Distribution of Contributor Awards contained in clause 2 is equitable.
Inventor 1:
Name
Signature
Inventor 2:
Name
Signature
Inventor 3:
Name
Signature
Date:
Executive Dean of Faculty
I have read the information contained in this invention disclosure and advise that to
the best of my knowledge and belief that all those persons listed as inventors in clause
2 have made a bona fide inventive contribution and there are no omissions, and the
proposed Distribution of Contributor Awards appears equitable.
Name
Signature
Date:
Please forward this form when completed to the Secretary of the IPCMC at
[email protected]. A signed copy must be sent to Bel Coppock at the Office
of Commercialisation, Level 1 Dow Corning Building, 3 Innovation Road, Macquarie
University, NSW 2109.
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