Licensing Disclosure
Form |
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This
form should be used if you want us to consider
a matter involving licensing of a patent,
copyright, trademark or trade secret. You
may fill-out this form and then return
it to us via email by pressing the “submit” button
at the end of this form. Alternatively,
you may print-out this form, fill-in the
requested information and return it to
us by U.S. post office mail or facsimile. |
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* Required Field |
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I. |
*Briefly
describe the subject matter of
the license you want to grant to
or that you want to accept from
another (for example, chemical
formula for testing water chlorine
level, apparatus for filtering
waste water, or process for making
gasoline, etc.): |
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II. |
Do you want only general advice
regarding granting and accepting
licenses rather than advice regarding
a specific set of facts?
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III. |
Does this matter involve granting
a specific license to another?
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IV. |
Does this matter involve accepting
a specific license from another?
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V. |
To the best of your knowledge,
does the subject matter of the
license concern a patent?
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VI. |
To the best of your knowledge,
does the subject matter of the
license concern a trademark?
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VII. |
To the best of your knowledge,
does the subject matter of the
license concern a copyright?
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VIII. |
To the best of your knowledge,
does the subject matter of the
license concern a trade secret?
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Our
Assurance of Confidentiality
Premier IP Protection, LLC hereby
agrees that licensing information
provided herein by the individual(s)
named in this Licensing Disclosure
Form will not be revealed, used,
disclosed, sold, or transferred
without his or her express authorization,
except if required by court order.
For Premier IP Protection, LLC:

Walter S. Stevens, Esq.
Manager Member |
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