Patent Disclosure Form

Patent Disclosure Form – Interest

Please complete this form to declare, on behalf of your organization, your patentable interests in the named work. If you do not have patentable interests, you should complete the TM Forum Patent Disclosure Certification Form – No Interests

Document name and version*
TM Forum Member company name*
On behalf of the above stated member company (“Member”), a TM Forum member, I hereby certify that (1) Member has reviewed the TM Forum Deliverable(s) and (2) In compliance with sections 8, 9.3, and 12 of the By-laws Annex 1: Policy on Intellectual Property Rights, Member has uncovered and discloses the patents and/or patent applications identified on Exhibit A hereto (Please include copies of all patents and patent applications.) as items which affect other TM Forum member’s ability to practice the above TM Forum Deliverable(s), and that aside from those items identified on Exhibit A hereto, Member does not at this time have knowledge of any other existing patents or patent applications which affect other TM Forum members’ ability to practice the above TM Forum Deliverable(s).
Patent numbers*
Copies of patent forms or other relevant information*
First Name*
Last Name*
Email*
Position*
Associated Country*
Date*
MM slash DD slash YYYY
Phone
This field is for validation purposes and should be left unchanged.

By clicking “Submit” below, you are electronically signing this agreement on behalf of your company. This electronic signature is equivalent to a normal signature.

Patent Disclosure form – No Interest

Please complete this form to confirm, on behalf or your organization, that you have no patentable interests in the named work. If you do have patentable interests, you should complete the TM Forum Patent Disclosure Certification Form – Declaration of Interest.

Document name and version*
TM Forum Member company name*
On behalf of the above stated member company ("Member"), a TM Forum Member, I hereby certify that to the best of my knowledge and in compliance with sections 8 and 12 of the By-laws Annex 1: Policy on Intellectual Property Rights, Member has reviewed the TM Forum Deliverable(s) and does not at this time have knowledge of any rights to any existing patents or patent applications which affect other TM Forum members' ability to practice the above TM Forum Deliverable(s).
First Name*
Last Name*
Email*
Position*
Date*
MM slash DD slash YYYY
Name
This field is for validation purposes and should be left unchanged.

By clicking “Submit” below, you are electronically signing this agreement on behalf of your company. This electronic signature is equivalent to a normal signature.