Intellectual Property Contact Form

Name

Email Address

Phone Number

Cellular or Pager

Address

City

State

Zip

Business Name

Business Address

City

State

Zip

Business Phone

Business Web Address

Describe the nature of your work as a work or authorship, symbol or trade name, invention or discovery, or matter of confidential business information.

If your work or idea is either derived from or similar to an existing idea or work belonging to another, describe how your work exceeds the scope of that prior idea or work in an innovative and creative way.

Was your idea or work made within the scope of your employment?
Yes No

Do you seek to have your idea or work protected for a limited period of time or indefinitely?
Yes No

Do you aspire to turn pecuniary (financial) profit from the use of your work?
Yes No

Do you intend to use, market or distribute your product or idea internationally?
Yes No

If yours is an invention, describe the useful nature of your invention and what benefit it will offer to individuals, to the advancement of science or arts, or to larger society.

If yours is an invention, describe how your invention or discovery is unique in ways that would not otherwise be thought of by others practicing in your field or industry.

If you are reproducing an otherwise copyrighted work, describe how you intend to educate, criticize or report the news with that reproduction.

If you are seeking protection of business information, describe the expenses you incurred in developing or acquiring that information as well as how many employees have access to that information.

If you are seeking monetary damages for the infringement on your intellectual property rights by another, describe and quantify both your losses in sales and expenditures made in effort to remedy the damage done to your business or reputation.

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