Software Form

Centro Brasileiro de Pesquisas Físicas - CBPF
Rua Dr. Xavier Sigaud, 150 - Urca
Edifício Min. J. A. Lins de Barros / Sala 315
Rio de Janeiro – RJ – Brasil – CEP: 22290-180
Tel: +55 (21) 2141-7277
www.nitrio.org.br
CREATION SUBMISSION FORM
SOFTWARE REGISTRY
1. DESCRIÇÃO DO REGISTRO DE PROGRAMA DE COMPUTADOR
1.1 - Title:
1.2 - Creation date:
1.3 - Language:
[ ] – confidential
1.4 - Guard system:
[ ] – non-confidential
1.5 - Briefly describe the content to be registered:
1.6 - Is this software a Technological Modification or a
Derivation?
[ ] – Yes
[ ] – No
1.6.1 – If answer to item 1.5 is positive, enter the Title of the Original Program and (if any)
Registration Number:
1.7 - Does this registry consist of work (s) of other subject of intellectual order? If so, check
it (them) below:
Centro Brasileiro de Pesquisas Físicas - CBPF
Rua Dr. Xavier Sigaud, 150 - Urca
Edifício Min. J. A. Lins de Barros / Sala 315
Rio de Janeiro – RJ – Brasil – CEP: 22290-180
Tel: +55 (21) 2141-7277
www.nitrio.org.br
[
[
[
[
[
[
] - Literature
] - Music
] - Arts
] - Audio-Visual
] - Architecture
] – Engineering
1.8 – Indication of Category of Field of Application and Software Type of registry:
Field of Application:
Software Type:
Note: These ratings should be filled according to the codes indicated by the INPI:
Application field(s):
http://www.inpi.gov.br/images/stories/downloads/programas/pdf/CAMPO_DE_APLICACAO.pdf
Types of software:
http://www.inpi.gov.br/images/stories/downloads/programas/pdf/TIPOS_DE_PROGRAMA.pdf
2. SOFTWARE AUTHORS
Note: The information below is necessary to fill the Software Registration Application Form at the
National Institute of Industrial Property (INPI).
AUTHOR - 1
Full Name:
Short Name:
Centro Brasileiro de Pesquisas Físicas - CBPF
Rua Dr. Xavier Sigaud, 150 - Urca
Edifício Min. J. A. Lins de Barros / Sala 315
Rio de Janeiro – RJ – Brasil – CEP: 22290-180
Tel: +55 (21) 2141-7277
www.nitrio.org.br
Passport Number:
Date of Birth:
Address:
Telephone:
E-mail:
Education / Qualification:
Institution:
Position:
Department:
AUTHOR - 2
Full Name:
Short Name:
Passport Number:
Date of Birth:
Address:
Telephone:
E-mail:
Education / Qualification:
Institution:
Position:
Department:
NOTE: Repeat the AUTHOR table above and include the required information for all
authors related to this request of software registration.
Centro Brasileiro de Pesquisas Físicas - CBPF
Rua Dr. Xavier Sigaud, 150 - Urca
Edifício Min. J. A. Lins de Barros / Sala 315
Rio de Janeiro – RJ – Brasil – CEP: 22290-180
Tel: +55 (21) 2141-7277
www.nitrio.org.br
3.
COMPUTER SOFTWARE OWNERSHIP
Note: Information below is necessary to fill in the Software Registration Application Form, at
the National Institute of Industrial Property (INPI).
DADOS DO TITULAR
Passport Number:
Name/Company name:
Short name, alias ou signal
of convenience (if
applicable ):
Nationality/Origin:
Address:
Telephone:
E-mail:
4. DISCLOSURE
4.1 – Has this computer program ever been made
available to the general public containing sufficient
description to enable a person skilled in this field, to
understand, reproduce or use this invention?
[ ] - Yes
[ ] - No
4.1.2 – If answer to item 4.1 is positive, please indicate how many times it has been released,
the location and the dates of disclosure.
Note: you should send documents with the content of disclosure (articles, abstracts of
articles, theses, oral presentation, etc.) to NIT-Rio, if you find it necessary.
Centro Brasileiro de Pesquisas Físicas - CBPF
Rua Dr. Xavier Sigaud, 150 - Urca
Edifício Min. J. A. Lins de Barros / Sala 315
Rio de Janeiro – RJ – Brasil – CEP: 22290-180
Tel: +55 (21) 2141-7277
www.nitrio.org.br