NASA FORM 1329 REV Instructions Jul 98 (Previous Editions Are Obsolete)

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| **  | **Inventions and           | **NASA Case      | **Date:**     |
| NAS | Contributions Board *Space | Number:**        |               |
| A** | Act Award Application***   |                  |               |
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**1. DESCRIPTION.**

> *a. Briefly describe the contribution. In addition, if peer-reviewed
> publications by contributors have been accepted on this topic in
> refereed journals or for refereed conference papers, please attach a
> copy with this form as a supplement.*
>
> *b. In what NASA program, project or mission has this contribution
> been used or will be utilized and to what extent*? (*include any
> non-aerospace commercialization applications)*
>
> *c. Provide details describing how the contribution works or operates
> relative to system, subsystem, components, etc.*

**2. SIGNIFICANCE.**

> *a. Explain why the contribution is significant: scientifically,
> technologically, or from a humanitarian viewpoint, to the aeronautics,
> space community, and non-aerospace commercial activities.*
>
> *b. Estimate the degree of scientific or technological significance by
> a mark on the line below:*

0\_\_\_\_\_\_\_\_\_\_\_1\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_2\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_3\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_4\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_5

***None*** ***Modest*** ***Average*** ***Major*** ***Maximum***

> *c. Estimate the significance of the contribution relative to a
> specific NASA program or mission by marking the line below:*

0\_\_\_\_\_\_\_\_\_\_\_1\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_2\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_3\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_4\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_5

***None*** ***Modest*** ***Average*** ***Major*** ***Critical***

**3. STAGE OF DEVELOPMENT.**

*Indicate the stage of development of the contribution by a mark on the
line below:*

0\_\_\_\_\_\_\_\_\_\_\_1\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_2\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_3\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_4\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_5

***Concept*** ***Simulated*** ***Tested*** ***Fully Developed***
***Operational***

> ***NASA Case Number: \_\_\_\_\_\_\_\_\_\_ 2***
>
> **4. ASSESSMENT OF USE.**
>
> *a.* If the contribution is not now in operation, describe its
> performance and value within both the aerospace field and its
> application to non-aerospace commercial and government uses.
>
> *b. If the contribution is not now in operational use, describe its
> most likely or previous applications and the extent of
> commercial,(includes non-aerospace commercialization) government
> and/or NASA-specific uses.*
>
> *c. Will the contribution increase in value or in its applications
> over time and in what manner?*

**5. CREATIVITY**.

> *What is your assessment of the creativity displayed in the conduct of
> this contribution, relative to the expected performance of those in
> similar positions?*
>
> *None\_\_\_\_\_\_\_\_Low
> \_\_\_\_\_\_\_\_\_\_Modest\_\_\_\_\_\_\_\_\_Average\_\_\_\_\_\_\_\_High\_\_\_\_\_\_\_\_\_Very
> High*\_\_\_\_\_\_\_\_\_\_\_

**6. RECOGNITION**

> *What forms of recognition have been received by the contributors for
> this contribution? Have*

*previous awards been made to the contributor(s) for this
accomplishment? Please describe.*

**7. TANGIBLE VALUE**.

> *As a measure of the tangible value of this contribution, estimate the
> following:*

*a. NASA cost savings\* to date and in future years.*

*b. Current market value and potential as a commercial product or
process.*

*c. Other measurable value: increased efficiency, enabling technology,
improved management, etc.*

**APPLICANT'S SIGNATURE:
[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}
DATE:[\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}**

*\*State the rationale for the above cost estimates*.

> ***NASA Case Number: \_\_\_\_\_\_\_\_\_\_ 3***

  -----------------------------------------------------------------------
  **SECTION II COMMENTS AND CONCURRENCE**

  -----------------------------------------------------------------------

> **1. EVALUATOR**

*I recommend/do not recommend a Space Act Award for this contribution
for the following reasons.*

  ----------------------- ----------------------- -----------------------
  *Printed Name and       *Title*                 *Date*
  Signature*                                      

  *NASA Installation*     *Contractor*            *Other*
  ----------------------- ----------------------- -----------------------

**2. EVALUATOR\'S SUPERVISOR**

> *I support/do not support a Space Act Award for this contribution for
> the following reasons.*

  ----------------------- ----------------------- -----------------------
  *Printed Name and       *Title*                 *Date*
  Signature*                                      

  ----------------------- ----------------------- -----------------------

**3. TECHNICAL MANAGEMENT**

> *I support/do not support a Space Act Award for this contribution for
> the following reasons.*

  ----------------------- ----------------------- -----------------------
  *Printed Name and       *Title*                 *Date*
  Signature*                                      

  ----------------------- ----------------------- -----------------------

**4. COMMERCIALIZATION MANAGEMENT**

> *I support/do not support a Space Act Award for this contribution for
> the following reasons.*

+--------------------+---+---------------+------+----------------------+
| *Printed Name and  |   | *Title*       |      | *Date*               |
| Signature*         |   |               |      |                      |
+--------------------+---+---------------+------+----------------------+
| **TO BE COMPLETED  |   |               |      |                      |
| BY AWARDS LIAISON  |   |               |      |                      |
| OFFICE**           |   |               |      |                      |
+--------------------+---+---------------+------+----------------------+
| **5.               |   |               |      |                      |
| IDENTIFICATION OF  |   |               |      |                      |
| CONTRIBUTORS**     |   |               |      |                      |
+--------------------+---+---------------+------+----------------------+
| *Name*             | * |               | *    |                      |
|                    | S |               | Home |                      |
|                    | o |               | Addr |                      |
|                    | c |               | ess* |                      |
|                    | i |               |      |                      |
|                    | a |               |      |                      |
|                    | l |               |      |                      |
|                    | S |               |      |                      |
|                    | e |               |      |                      |
|                    | c |               |      |                      |
|                    | u |               |      |                      |
|                    | r |               |      |                      |
|                    | i |               |      |                      |
|                    | t |               |      |                      |
|                    | y |               |      |                      |
|                    | N |               |      |                      |
|                    | u |               |      |                      |
|                    | m |               |      |                      |
|                    | b |               |      |                      |
|                    | e |               |      |                      |
|                    | r |               |      |                      |
|                    | * |               |      |                      |
+--------------------+---+---------------+------+----------------------+
|                    |   |               |      |                      |
+--------------------+---+---------------+------+----------------------+
|                    |   |               |      |                      |
+--------------------+---+---------------+------+----------------------+
|                    |   |               |      |                      |
+--------------------+---+---------------+------+----------------------+
|                    |   |               |      |                      |
+--------------------+---+---------------+------+----------------------+
| > ***NASA Case     |   | ***4***       |      |                      |
| > Number\_\_\      |   |               |      |                      |
| _\_\_\_\_\_\_\_*** |   |               |      |                      |
+--------------------+---+---------------+------+----------------------+
| **6. PATENT        |   |               |      |                      |
| INFORMATION**      |   |               |      |                      |
+--------------------+---+---------------+------+----------------------+
| *Patent Applied    |   | *Serial       |      |                      |
| for? Y/N Granted?  |   | Number or     |      |                      |
| Y/N*               |   | Patent        |      |                      |
|                    |   | Number*       |      |                      |
+--------------------+---+---------------+------+----------------------+
| *Application filed |   | *Date Filed   |      |                      |
| by: Government?*   |   | or Granted*   |      |                      |
|                    |   |               |      |                      |
| *Non-Government?*  |   |               |      |                      |
+--------------------+---+---------------+------+----------------------+
| *License Granted   |   | *Company      |      |                      |
| Y/N*               |   | Name:*        |      |                      |
+--------------------+---+---------------+------+----------------------+
| **7. EVALUATION    |   |               |      |                      |
| NUMBER 1 2 3**     |   |               |      |                      |
+--------------------+---+---------------+------+----------------------+

  -------------- ----------------------- -------------------------------- ------------- --
  **8. BUSINESS                                                                         
  ADDRESS OF                                                                            
  CONTRIBUTORS                                                                          
  IF OTHER THAN                                                                         
  NASA                                                                                  
  EMPLOYEES**                                                                           

                 **9. AWARD LIAISON                                                     
                 OFFICER COMMENTS AND                                                   
                 SIGNATURE**                                                            

                 *Printed Name and       *Comments*                       *Date*        
                 Signature*                                                             
  -------------- ----------------------- -------------------------------- ------------- --