PATENT TEMPLATE RESEARCH AND DEVELOPMENT CENTRE M. S. ENGINEERING COLLEGE, BANGALORE-562110 Sl. No. ____

Date:

INVENTION DISCLOSURE FORM TITLE OF THE INVENTION: The specification must start with a title, which is short, and, which describes the general nature of invention. The title should not contain anyone's name, a fancy name and trade name or personal name or any abbreviation Example: Swimsuit withINFORMATION drowning alert indicator I. CONTACT

1. Name and Nationality of the main inventor: Name

Home Address

Dr. Cyril Prasanna Raj P.

No. 6, Sanas Cottage, 3rd Cross, 1st main, Narayana Reddy layout, Chola Nagar R. T. Nagar PO, Bangalore32

Citizenship Indian

Mobile No

E mail id

9448686332

cyrilyahoo@gm ail.com

2. Name and Nationality of the additional inventors: Name Dr. Sreerama Reddy G. M.

Home Address No. 26, 5th Cross, Sumangali Sevashrama Road, Hebbala, Bangalore. – 560 024.

Citizenship Indian

Mobile No 9738481799

E mail id Sreeramareddy90@gmail .com

II. FUNDING SUPPORT FOR THIS INVENTION 1. Sponsoring agency: (a) Was this invention developed under any project funds): YES (b) If yes Name of the funding agency along with the reference details:

III. ABOUT THE INVENTION 1. Field of the Invention

NO

2. Novelty of the invention

3. Innovative features

4. Abstract of the Invention

5. Background of the invention

6. Existing state – of – art related to the invention (includes patent, literature search)

a. The kind of Patent search you request (tick) 6.1. Prior –art / 6.2 Freedom to operate / 6.3. (Invalidity/Validity) 6.4. Infringement /6.5. Bibliographic / 6.6. Continuing / 6.7. (Inventor/assignee) 7. Drawbacks in existing state-of-art and how the drawbacks have been overcome and advantages of your invention.

8. Detailed description of the invention

9. Industrial application of the invention

10. List of keywords (in capital letters) relevant to the invention

IV. PUBLIC DISCLOSURE 1. Has the invention been described or discussed in any journal, abstract paper, oral presentation, news story, thesis or other medium? YES NO a) If yes give the details

V. USE OF PROPRIETARY MATERIALS 1. Indicate whether any part of the invention is based on, or was made possible by the use of, Proprietary material(s) or special technique(s) obtained from a third party (such as a company or another institution). 2. Did this research use any biological material from outside? YES NO a. If yes, please mention the geographical origin of biological material used for the invention

b. If so, have you deposited the biological material in an International Depository Authority? YES NO c. Name and address of the International Depository Authority

d. Date and number of deposition of Biological material:

VI. MARKET EVALUATION 1. Whether your invention is concept only, laboratory tested or prototype.

2. List the products or process that competes with your invention?

3. Suggest few companies (along with their complete contacts) which may be interested in your invention?

4. Approximate commercialization value of your invention:

VII. GENERAL INFORMATION (Only for the invention of MSEC which are not sponsored through funding agency) 19. List of three expert members (along with their complete contact details) in the field of proposed invention (preferably in and around Bangalore).

VIII. SIGNATURE PAGE I/We the undersigned inventor(s), through my/our activities at MSEC, hereby disclose this “Invention” to the R&D Centre, MSEC, Bangalore on the date last signed below. I/We understand that my/our obligations regarding this Invention are governed by the Anna University “IPR Policy”. Signature of the Inventor(s) By: By: Name: Name: Date: Date:

By: Name: Date:

By: Name: Date: ( Attach additional Signature Pages, if necessary)

Please submit the completed Invention Disclosure Form, Detailed Specification of the invention and Signature Page signed by all inventors to: The Dean, Research and Development Centre, MS Engineering College, Bangalore – 562110

FOR OFFICE USE ONLY 1. Name of the Person who made the Search: 2. Kind of search made Prior –art / Patentability / Freedom to operate / (Invalidity/Validity Infringement /Bibliographic / Continuing / (Inventor/assignee) 3. Name of the person who drafted the specification: 4. Kind of specification: 1. Provisional 2. Complete 5. Date of Filing the provisional specification to the patent office: / /20 6. Date of Filing the Complete specification to the patent office: / /20 7. Date of request for publication: / /20 8. Date of request for examination: / /20 9. Initiatives taken for commercialization:

10. Actions taken by the patent office:

11. Details of any pre grant oppositions filed:

12. Date of counters filed to the Patent office:

14. Date of Grant of patents:

/

/20

15. Details of any post grant oppositions:

16. Details of Final Decision on the Patent: