Humanitarian Research Form

A pplication

OMB 0651-0066 Approved for use through 7/31/12.

U.S. Patent and Trademark Office; U. S. DEPARTMENT OF COMMERCE

Under the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number.

Humanitarian Research Form

Applicant(s): _______________________________________________________________________________

Application Category (select one): ____ Medical ____ Food & Nutrition

____ Clean Technology ____ Information Technology

Instructions: In no more than five pages, please address the following criteria for Humanitarian Research. If your application covers Humanitarian Use, please use the Use form instead.

Humanitarian Research

1. Research Impact – the applicants’ technology that is claimed in a U.S. utility patent in force at the time or a pending U.S. utility patent application has made a significant contribution to substantial research conducted by others which clearly targets a humanitarian issue;

a. What technologies does this application concern? Each technology must be claimed in one or more U.S. utility patents or pending U.S. utility patent applications to be eligible for this program. Please provide all patent or application numbers with a brief description of each technology.

b. What other researchers (i.e. not affiliated with any of the applicants) are using these technologies (or products based on these technologies) for research projects targeting humanitarian issues?

c. What humanitarian issues are they researching?

d. What contribution do the technologies (or products) in part (a) make to these particular research projects?

2. Neglected Field – the research by others occurs in an area lacking significant commercial application; and

a. Describe why these research projects by others lack significant commercial application.

3. Contribution– the applicants took significant action to make the technology available to the other researchers.

a. What actions have the applicants taken to make use of the technology (or products) described in part 1(a) available to the researchers in part 1(b) for their research? Please explain what actions the applicants named on this application have taken themselves, and how those actions differ from ordinary conduct in this field (e.g. normal commercial transactions).

It is estimated that the Humanitarian Award Application will take 4 hours to complete. Applying for the Award is voluntary; however, if you apply you must provide the information requested. Failure to provide this information may delay or prevent processing of your application. Please send any comments on the amount of time required to complete this form and/or suggestions for reducing the time burden to the Chief Information Officer, USPTO, PO Box 1450, Alexandria, VA 22313-1450. DO NOT SEND APPLICATIONS TO THIS ADDRESS

Answers

1a.

1b.

1c.

1d.

2.

3.

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