Paperwork Reduction Act Statement: This information collection meets the requirements of 44 U.S.C 3507, as amended by section 2 of the Paperwork Reduction Act of 1995. You do not need to answer these questions unless we display a valid Office of Management and Budget control number. The OMB control number for this information collection is 2700-0169 and it expires on 12/31/2021. We estimate that it will take about 8 hours to read the instructions, gather the facts, and answer the questions. You may send comments on our time estimate above to [email protected]. Send only comments relating to our time estimate to this address.
How did you originally find out about NASA Tech Transfer?
Please select from the list of options.
Web Search
Inventor Paper/Presentation
In-Person or Virtual Event (Conference, NASA Visit, etc.)
Technology Transfer Program Webinar
Technology Transfer Program Staff Contact
Inventor Contact
Email Newsletter
Federal Govt Contract Opportunity Announcement (SAM.gov, etc.)
NASA Technology Transfer Twitter Account
NASA Spinoff Facebook Page
NASA Technology Transfer LinkedIn Page
NASA Spinoff YouTube Account
NASA T2X or T2U
Other
Please provide additional details.
Next we need to know some information about your company.
Is your company already legally formed?
Type of Company:
Please enter the company type for the option "Other".
Select the choice that your company qualifies as.
Check the box for any of these that apply to your company.
Small Disadvantaged Business
8(A) Business Development Program
HUBZone
Woman Owned Small Business
Service Disabled Veteran Owned Small Business
Minority Serving Institution
Historically Black College/University
Company Name:
Country:
Street Address:
City:
State / Province:
Zip Code:
Date of Incorporation:
Place of Incorporation:
Unique Entity Identifier (UEI):
How many employees does your company currently have?
Describe your company's nature / type of business, including any products or services that have already been commercialized.
Link to online annual report, if available.
Annual Report Text:
Annual Report Attachment:
US Owned Company
Is your company a domestic U.S. owned company?
What country is your headquarters located in?
Does your company have a U.S. presence?
What is the name of the U.S. company?
What is the state the company is incorporated in?
Parent Company
Does your company have a parent company?
Parent company name:
Parent company address:
Company Point of Contact (POC)
POC First Name:
POC Last Name:
POC Title:
POC Phone Number:
POC Email Address:
POC Citizenship:
POC Country of Citizenship:
Signatory is same as Company POC
Signatory Name:
Signatory Title:
Signatory Citizenship:
Is this application related to an SBIR/STTR TAV proposal?
Has your company previously licensed any federal technologies?
Are you currently applying to license any other NASA technologies?
Next are a few questions about how you intend to use this technology.
Describe the product(s), process(es), or service(s) you are proposing to create, evaluate or enhance using a license on this technology. Be detailed and specific.
What field(s) of use would you propose your license to cover? (What is the intended market application, or field of use, for this technology?)
To what extent are similar technologies currently being practiced in the market, and what is their commercial availability?
What economic benefits will your proposed use of the technology generate for the United States?
What market sectors (industries) are you targeting?
What is the market size for your particular application?
Provide any additional information or context that you believe will support a decision to grant your company a license.
DEVELOPMENT & MARKETING PLANS: TIME & FUNDING
How long do you anticipate it will take to make the product market ready?
How much funding do you anticipate it will take to develop and commercialize this product?
What funds do you currently have?
Please provide more information about this funding.
Please describe any other financial resources that will help you develop the end product, including anticipated future sources of funding.
Please provide a 5 year projection of expenses and income as they relate to the technology to be licensed from NASA using the following pro-forma spreadsheet sample.
DEVELOPMENT & MARKETING PLANS: DESIGN & MANUFACTURING
Please describe for us your plans for designing, developing, and selling the product, process, or service.
Please describe your technical resources that will help bring this product to market.
What is the US ZIP code/ non-US postal code where the product will be designed/developed?
Where do you intend on manufacturing any products embodying the invention, and where do you intend to use or sell the product(s)?
Please describe for us your marketing plan
Please describe your marketing & business development resources that will help you effectively market your product/service.
Which commercial market do you intend to enter?
Are there any additional market sectors you plan on entering after initial success?
Please provide a list of significant performance milestones. These will be incorporated into the licensing agreement.
DEVELOPMENT & MARKETING PLANS: ROYALTIES
NASA's royalty structure for commercial licenses typically includes the following three components: an initial fee, an annual minimum royalty and a running royalty percentage of sales. These amounts are negotiated with the licensing team. Please propose royalty amounts below.
Proposed initial fee to be paid upon license execution:
Proposed running royalty based on percentage of sales.
Annual minimum royalty
To ensure that NASA and your company fully understand what's considered royalty based, please propose what product/service sales your company believes it will pay royalties on.
DEVELOPMENT & MARKETING PLANS: TIME & FUNDING
How long do you anticipate it will take to make the product market ready?
How much funding do you anticipate it will take to develop and commercialize this product?
What funds do you currently have?
Please describe any other financial resources that will help you develop the end product, including anticipated future sources of funding.
DEVELOPMENT & MARKETING PLANS: DESIGN & MANUFACTURING
Please describe for us your plans for designing, developing, and selling the product, process, or service.
Please describe your technical resources that will help bring this product to market.
What is the US ZIP code/ non-US postal code where the product will be designed/developed?
Where do you intend on manufacturing any products embodying the invention, and where do you intend to use or sell the product(s)?
Please describe for us your marketing plan.
Please describe your marketing & business development resources that will help you effectively market your product/service.
Which commercial market do you intend to enter?
Are there any additional market sectors you plan on entering after initial success?
Please provide a list of significant performance milestones. These will be incorporated into the licensing agreement.
DEVELOPMENT & MARKETING PLANS: ROYALTIES
NASA's royalty structure for commercial licenses typically includes the following three components: an initial fee, an annual minimum royalty and a running royalty percentage of sales. These amounts are negotiated with the licensing team. Please propose royalty amounts below.
To ensure that NASA and your company fully understand what's considered royalty based, please propose what product/service sales your company believes it will pay royalties on.
Describe the product(s), process(es), or service(s) you are proposing to develop with this technology.
What field(s) of use would you like this license to cover?
How long will it take you to evaluate the technology and submit a report to NASA detailing the results?
What is the ZIP code where the research or development work will be performed?
What will be your approach for evaluating & developing the technology during this research license? (What methods will you use?) Be detailed & specific.
What resources will you use to enable your research/evaluation/development of the technology? Be detailed & specific.
Please provide a list of significant research milestones for the you've requested above. These will be subject to NASA approval and incorporated into the licensing agreement. You should propose milestones relative to the license execution date. For example "License Executed (LE) plus 3 months, LE plus 6 months, etc."
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | Okimura, Takeshi J. (ARC-TI) |
| File Modified | 0000-00-00 |
| File Created | 2023-07-29 |