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Your content will be deleted if left idle for a more than 1 hour. 1 Contact Information Inventor Legal Name: * Email Address: * Confirm Email: * Primary Phone: * Secondary Phone: Street Address: * City: * State: * State Alabama Alaska Arizona Arkansas California Colorado Connecticut District of Columbia Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon OTHER Zip: * Country: * United States Canada Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegowina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Congo, Democratic Republic Cook Islands Costa Rica Cote d'Ivoire Croatia (Hrvatska) Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France France, Metropolitan French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Heard and Mc Donald Islands Holy See (Vatican City State) Honduras Hong Kong Hungary Iceland India Indonesia Iran (Islamic Republic of) Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea, Democratic People's Republic Korea, Republic of Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libyan Arab Jamahiriya Liechtenstein Lithuania Luxembourg Macau Macedonia,Fmr Yugoslav Republic Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia, Federated States of Moldova, Republic of Monaco Mongolia Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russian Federation Rwanda Saint Kitts and Nevis Saint LUCIA Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Seychelles Sierra Leone Singapore Slovakia (Slovak Republic) Slovenia Solomon Islands Somalia South Africa South Georgia/S. Sandwich Islands Spain Sri Lanka St. Helena St. Pierre and Miquelon Sudan Suriname Svalbard and Jan Mayen Islands Swaziland Sweden Switzerland Syrian Arab Republic Taiwan, Province of China Tajikistan Tanzania, United Republic of Thailand Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Venezuela Viet Nam Virgin Islands (British) Virgin Islands (U.S.) Wallis and Futuna Islands Western Sahara Yemen Yugoslavia Zambia Zimbabwe Co-Inventor? (if applicable) Co-Inventor First Name Co-Inventor Last Name InventionHome's 100% Confidentiality Guarantee I understand and agree to the Confidential Invention Disclosure * Next→ Invention Disclosure Agreement This agreement is in consideration of the disclosure of Confidential Information as defined herein by the disclosing inventor(s) to InventionHome (d/b/a of Jacob Enterprises, Inc.). InventionHome hereby agrees to hold and maintain the Confidential Information in strictest confidence, to not disclose the Confidential Information to any third party and to use the Confidential Information only for purposes of analyzing and evaluating opportunities to sell or distribute products based on the Confidential Information. "Confidential Information" shall include all technical or business information relating to the products and/or inventions identified within and provided to InventionHome. "Confidential Information" shall not include any information that is: (a) publicly known at the time of disclosure or subsequently becomes publicly known through no fault of InventionHome; (b) already known to InventionHome at the time it was disclosed or independently developed by InventionHome without the benefit of the Confidential Information; or (c) learned by InventionHome through legitimate means from a third party who has the right to disclose it without restriction. The confidential disclosure statement above is designed to protect your idea and to provide InventionHome's guarantee of confidentiality. We value the confidentiality of your invention. InventionHome’s core business is to provide assistance to inventors in securing 3rd party licensing agreements for new product inventions. InventionHome also offers services to assist with patent searching conducted through an independent, registered patent attorney and an advisory service to assist in filing a Provisional Patent Application, which includes grammar, spelling, and overall presentation. InventionHome is not a law firm and cannot offer legal services or opinions relating to the sufficiency or technical aspects of a provisional patent application for any purpose including patentability or market potential. We do offer patent attorney / agent referrals when appropriate. I understand that InventionHome will not evaluate my invention for market potential or patentability and cannot guarantee or offer opinions on my product's market success potential. Further, I understand that the patent process may be used to protect my rights as an inventor and that InventionHome has not provided me with legal advice. I am confidentially disclosing my invention to InventionHome only for their assistance in marketing my invention to potential licensees and that further action may be required in the United States Patent & Trademark Office by me to secure utility and/or design patent protection. Corporate Signature: InventionHome Russel Williams Russel Williams President × Close ▣ Print © Jacob Enterprises, Inc. (d/b/a: InventionHome) All rights reserved. Call Us: 1-866-844-6512 or Email Us: support@inventionhome.com Terms of Service | Privacy Policy | Disclaimer...