Premier IP Protection, LLC
"Our Law Firm Protects Your Creativity"
Premier IP Protection, LLC
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Trade Secret Disclosure Form

This form should be used if you want us to consider a trade secret matter.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.

* Required Field
*Your Name:
(first, middle, last)
Home Address:
Mailing Address:
City:
City:
State:
State:
Zip:
Zip:
*Home Phone:
Other Phone:
Fax:
*E-mail:
I.
*Briefly describe the subject matter of the trade secret (for example, chemical formula for testing water chlorine level, or apparatus for filtering waste water, process for making gasoline, etc.):
II.
Do you only want general advice regarding how to protect your trade secrets?
III.
Does this matter involve theft of the trade secret by a specific competitor?
IV.
Does this matter involve theft of the trade secret by your employee?

Our Assurance of Confidentiality
Premier IP Protection, LLC hereby agrees that any information pertaining to information provided by the owner(s) of the trade secret named in this Trade Secret Disclosure Form will not be revealed, used, disclosed, sold, or transferred without the express authorization of the owner(s) of the trade secret, except if required by court order.

For Premier IP Protection, LLC:
Walter S. Stevens
Walter S. Stevens, Esq.
Manager Member

Submitter's Statement
By submitting this Trade Secret Disclosure Form and any other information pertaining to the trade secret, I acknowledge that Premier IP Protection, LLC is accepting this information for review purposes only.  I understand that any comments that I receive based upon this review are based upon a limited analysis and is neither meant nor understood to be a conclusive legal opinion.  Further, I agree that Premier IP Protection, LLC cannot be held responsible for any recommendations based upon the review of the information herein and cannot be held responsible for the return of any submitted materials.  Even if no signature(s) for the owner(s) of the trade secret is/are included in the submitted form, I/we acknowledge that the submission of this Trade Secret Disclosure Form shall indicate my agreement to this Trade Secret Owner’s Statement.

Signature**:
Date

** There is no need sign this form, if returning this form online. It will be assumed that the completed form is from the individual whose name appears above.

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