KSU
Kingdom of Saudi Arabia
Ministry of Higher Education
King Saud University
Vice- Rectorate for Graduate Studies and Scientific Research
Intellectual Property and Technology Licensing Program
Invention Disclosure Form
Confidential Information
|: |File NO. |
|: |Receiving Date |
|: |Title of Invention in Arabic |
|: |Title of Invention in English |
▪ First Inventor Information:
|: |Full name in Arabic |
|: |Full name in English |
|: ( Yes ( No |KSU staff Member |
|: |Nationality |
|: |Job title |
|: |Department |
|: |College/Administration |
|: |Address |
|: |Email Address |
|: |Phone Work |
|: |Mobile |
▪ Co-Inventors (if any)
▪ Second Inventor Information:
|: |Full name |
|: ( Yes ( No |KSU staff member |
|: |Nationality |
|: |Job title |
|: |Department |
|: |College/Administration |
|: |Email Address |
|: |Mobile |
▪ Third inventor Information:
|: |Full name |
|: ( Yes ( No |KSU staff member |
|: |Nationality |
|: |Job title |
|: |Department |
|: |College/Administration |
|: |Email Address |
|: |Mobile |
▪ Fourth Inventor Information :
|: |Full name |
|: ( Yes ( No |KSU staff member |
|: |Nationality |
|: |Job title |
|: |Department |
|: |College/Administration |
|: |Email Address |
|: |Mobile |
▪ In case, there is a co-inventor[1], please provide us the following:
|Frist Inventor: |The Inventors Contribution |
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|Second Inventor: | |
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|Third Inventor: | |
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|Forth Inventor: | |
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|: …… % |First Inventor |The Percentage of Inventors Contribution |
|: …… % |Second Inventor | |
|: …… % |Third Inventor | |
|: …… % |Fourth Inventor | |
▪ A Detail Description of the Invention:
- Please write a full description of the invention[2], ( please attach a file including a full description ):
|First: Abstract of the Invention |
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|Second: Background of the Invention: |
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|Third : A Detail Description of the Invention |
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▪ Are there sketches that illustrate the invention[3]? ( Yes ( No
If yes, please attach them, making sure that the name clearly describes the sketch. Please note that providing us with sketches will help us process your application faster.
▪ What was the approximate date of conception of the invention?
|Year: |Month: |
▪ What are the potential practical and commercial applications of the invention?
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▪ Has this invention resulted from a previous or existing research project? ( Yes ( No
If yes, please provide the project number and the name of the sponsor or a copy of the contract:
| |Authority is funding / supporting this research |
|, / / |No. and date of supported this research |
|( KSU ( KSU and Other Authority ( Others |The owner of the intellectual property rights resulting |
| |from this research |
▪ Have you previously filed for a patent for this invention[4]? ( Yes ( No
If yes, please provide us the following:
| |Filling Patent office/offices |
| / / |The Date of Filing |
|( Approved ( Under Review ( Denied |The Status of Patent Application |
▪ A Prior Disclosure of the Invention[5]:
|( Yes ( No |Has this invention been disclosed (brief or in detail) in writing in any publication? |
| |If yes, please provide the following: |
| |Title of Publication: ………………………………………………………………………………………… |
| |The Place of Publication: …………………………………………….……..…………………………… |
| |The Date of Publication: ……………………………………………….….…………………………..… |
|( Yes ( No |Have you presented the idea(s) of this invention orally (brief or in detail) in a public gathering? |
| |If yes, please provide the following: |
| |The Place of Presentation: ……………………………………………………………………………. |
| |The Date of Presentation: ……………………………………………………………….……………. |
|( Yes ( No |Has the invention been manufactured and used? |
| |If yes , please answer the following: |
| |The Place and the Date of Manufacturing/using: …………………………………..……… |
| |The Purpose of Manufacturing/Using: ………………………….………………………………… |
▪ Has a prototype been manufactured for your invention? ( Yes ( No
If No, would you like KSU to fund building a prototype to verify the viability of the invention[6]?
( Yes ( No
▪ Are there companies that you think would be interested in utilizing the invention? ( Yes ( No
If yes, please list names of up to three companies:
1. .........................................................
2. .........................................................
3. .........................................................
If there is any further information that you would like to add;
Please attach it to the application[7]
DECLARATION
I/We declare that the information mentioned in this form is correct, and I/We declare King Saud University's eligibility in the ownership of the patent in the case of registration, in accordance with the bylaws of the Intellectual Property and Technology Licensing Program, (IPTL Program) dated 22/11/1430h corresponding to 10/11/2009g, and the Law of Patents, Layout Designs of Integrated Circuits, Plant Varieties, and Industrial Designs No. (M/27) dated 29/5/1425h, and I/We pledge to sign all official documents related to this matter especially the Declaration and Assignment required by patent offices.
I/We declare not disclosing the invention during it’s studying by the IPTL Program, I/we also declare not to participate with the invention in seminars, exhibitions, conferences and etc. only after obtaining the written approval by the IPTL Program.
I/We declare not to take any action or initiatives concerning licensing the invention, with obligatory not to negotiate or sign any contract, agreement, memorandum of understanding or etc., with institutions, companies or etc. from outside the university, or any others within the university; Only through IPTL Program as a representative of King Saud University the exclusive owner of the intellectual property rights.
This, in the case of violation of all or part of the above, I/We bear regulative and financial responsibility implications thereof.
1. Name of Inventor: ………………………………………… Signature: ………………………… Date: ………………
2. Name of Inventor: ………………………………………… Signature: ………………………… Date: ………………
3. Name of Inventor: ………………………………………… Signature: ………………………… Date: ………………
4. Name of Inventor: ………………………………………… Signature: ………………………… Date: ………………
- Please send this invention disclosure form to the following e-mail: iptl@ksu.edu.sa
- For further information, please call the following telephone number: 4693116 - 4693117
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([1]) It should be noted that, to decide the shave contribution of the inventors, please note the following:
1. If the subject of the invention is a joint work of several inventors, they have equal contribution, unless they agree otherwise.
2. It is essential to contribute to core subject of the invention or at least port of the claims. In order to be considered on of the inventions. Therefore, anyone who is not part of the mension above and just helped to facilitate the way to get the invention is not. Considered by rules one inventor. Thus, any one is not considered one of the inventors of his contribution is one of the following:
– To submit a proposal, conception or guidance to solve a specific problem, without having a material way to implement this idea, or to achieve the final result, or a solution to the problem.
– His Contribution is normal; do not involve the actual contribution in one of the new elements to be protected in the invention.
– His contribution is only implementation of the instructions and directions from person(s) who have reached the final result or solution to a problem.
– His role is just a supervisor or head of department or director of a laboratory, do not provide a direct and large contribution (innovative contribution) in the implementation of invention.
– His role is limited to providing financial support for research, or machinery, or laboratories necessary in carrying out the invention.
([2]) A full description must include the following parts:
– Background of the invention: must describe the technical field of the invention and describe the status of the prior art, including any related documents to the invention, with mention of any problems related to the prior art of the invention that could be solve.
– General description of the invention: it shows the features of the invention compared to prior art and how to overcome the earlier difficulties or problems, as indicating the aim of the invention, and has to be obvious way so that the regular technician can understand, and it usually regard this part as primary element for protection.
– A brief explanation of the drawings: It shows a brief explanation of the forms and sectors, if any.
– Detailed Description: The description should be clear and sufficient to enable a knowledgeable person implementing the invention, and should include a detailed explanation of the invention as well as the inventor must also shows the best way known to the inventor for carrying out the invention at the filing date or priority date. The explanation must include a reference to the accompanying illustrations in detail.
– Finally, the applicant should highlight the new elements to be protected in the invention in a specific and clear way , so that prevent others to imitate him; by defining its components and technical characteristics, and what is new and represents an inventive step in the invention, to distinguish it from any other invention.
([3]) Please note that you should provide us with detailed figures that describe the invention exactly. Do not attach general figures or drawings that are not related to the core subject of the invention or the new claims that need to be protected.
([4]) The applicant is obligated to provide complete information about all previous filed applications of this invention to the other authorities, and provide the results of these filed application, so that we could act according to the regulations.
([5]) The applicant is obligated to disclose prior disclosure (orally, in writing or using the invention) either at conferences, national or international exhibitions, etc. and the date of disclosure, and the reasons for it. In all cases, provide all documents that show the precedence or prior disclosure of the invention.
([6]) It should be noted that building prototype of the inventions cannot be implemented until the registration of the application and filing it to one of patent offices. In addition manufacturing of these prototypes are subject to other considerations, the most important ones are the potential commercialization of the invention, and the necessary financial support for implementing this invention.
([7]) Please, attach a full description of the invention supported by drawings in PDF or Word. As well as any information that may be necessary to aid the possibility of registration and especially the references you referred to in the disclosure, whether they are patents, patent applications or scientific publication (please, mention patent number or a number of the patent application, and attach full text of scientific papers).
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