Information to be supplied in a disclosure

Employees or consultants of the Veterans Administration should supply the following information through channels to the General Counsel. (See the Transfer Officer or VA regulation 657.)

1. Give title of invention, VA project number, grant or contract number.
   
   
2. State inventor's full name, business address, phone number, title or position.
   
   
3. Provide copy of position description of inventor at time of invention.
   
   
4. Give name and address of facility where the invention was made.
   
   
5. State contribution of the VA to the invention in
   
   

   - personnel

   - time

   - equipment

   - facilities

   - materials

   - technical information

   
   
6. State contribution of other organization(s) to the invention in
   
   

   - personnel

   - time

   - equipment

   - facilities

   - materials

   - technical information

Investigator

Transfer Officer

Center Director