NASA Dryden Flight Research Center

Technology Utilization Office

P.O. Box 273, Mail Stop MS4839

Edwards, CA 93523-3119

NASA John H. Glenn Research Center at Lewis Field

Technology Transfer & Partnership Office

21000 Brookpark Road, M S 4-2

Cleveland, Ohio 44135

<Kathleen.A.Kerrigan@grc.nasa.gov>

NASA Goddard Space Flight Center

Technology Transfer Program

Greenbelt Road - Mail Stop 504

Greenbelt, MD 20771

NASA Headquarters\
Office of the General Counsel

Attn: Agency Counsel for Intellectual Property

Suite 9T39\
300 E. Street, S.W.\
Washington, D.C. 20546

Jet Propulsion Lab

Attn: JPL SBIR Program Office

4800 Oak Grove Drive,

Mail Stop 249-103

Pasadena, Ca 91109-8099

<SBIR.Program.Office@jpl.nasa.gov>

NASA Johnson Space Center

Technology Transfer & Commercialization

2101 NASA Road 1 - Mail Stop HA

Houston, TX 77058-3696

NASA John F. Kennedy Space Center

Attention: Technology Transfer Officer

Technology Transfer Office, Mail Stop YA-C1

Kennedy Space Center, FL 32899

NASA Langley Research Center

Patent Counsel Office

3 Langley Blvd. - Mail Stop 212

Hampton, VA 23681-2199

NASA George C. Marshall Space Flight Center

Technology Transfer Department

New Technology Representative/CD3O

MSFC, Alabama 35812

<Carolyn.E.McMillan@msfc.nasa.gov>

NASA Stennis Space Center\
Attn: Intellectual Property Manager

Technology Development and Transfer Office\
Mail Stop HA30\
Stennis Space Center, Mississippi 39529-6000

NASA contracts, grants, cooperative agreements, and subcontracts
(Funding Agreements) for experimental, developmental or research work
require each Contractor/Grantee/Subcontractor (C/G/S) to report New
Technology Items to NASA. For that purpose, the following reports and
corresponding schedules are provided:

#  Title of Report/Form Schedule for Submission

**Disclosure of Invention and New Technology (Including Software)**
*NASA Form 1679 or equivalent information required*
([http://invention.nasa.gov](http://invention.nasa.gov/) for access to
form or on-line reporting)

New Technology Summary Report (NTSR)

*(check marked **"Interim"**)*

**New Technology Summary Report (NTSR)**

*(check marked **"Final"**)*

The C/G/S must submit a detailed disclosure of **each** New Technology
Item (reportable item or subject invention -- see definition below) made
under the funding agreement **within two months after innovator's
disclosure to the C/G/S.**

For multi-year efforts, the C/G/S must submit a summary listing of all
New Technology Items developed during the reporting period, OR provide
certification that there were none. The first Interim New Technology
Summary Report **is due 12 months from the effective date of the effort.
Additional reports are due annually thereafter.**

The C/G/S must submit a cumulative summary listing of all New Technology
Items developed during the **entire performance** of the Funding
Agreement, OR provide certification that there were none. The Final New
Technology Summary Report **must be submitted within 3 months of
completion of work under the funding agreement**.

Submitting C/G/S Name and Address:

**C/G/S New Technology Representative:**      

**Report Submitted by:**      

**(if not New Technology Representative)\
**

**Contact Telephone Number:** (   )     -      **Contact Email
Address:**      

## NASA Funding Agreement Number:       Funding Agreement Completion Date:   /  /    

**Title of Funded Activity:**      

## NASA Project Manager/\*COTR or Grant Monitor:      

**Report** **Submission Date:**   /  /    

**[Definition of New Technology Items]{.underline}**

**Large business** **C/G/S** must disclose all **reportable items** to
NASA. Reportable item as used in NASA Funding Agreements with large
businesses means any invention, discovery, improvement, or innovation,
**whether or not patentable,** conceived or first actually reduced to
practice in the performance of work under a NASA Funding Agreements.
Reportable items include, but are not limited to, new processes,
machines, manufactures, and compositions of matter, and improvements to,
or new applications of, existing processes, machines, manufactures, and
compositions of matter. Reportable items also include new computer
programs, and improvements to, or new applications of, existing computer
programs, whether or not copyrightable.

**Small business, nonprofit organization, and college and university
C/G/S** must disclose all **subject inventions** to NASA. Subject
invention as used in NASA Funding Agreements with other than large
businesses means any invention or discovery which **is or
[may]{.underline} be patentable** and is conceived or first actually
reduced to practice in the performance of work under a NASA Funding
Agreements. Subject inventions include any new process, machine,
manufacture, or composition of matter, including software, and
improvements to, or new applications of, existing processes, machines,
manufactures, and compositions of matter, including software.

**Note**: Subject to approval by C/G/S who retain or obtain title to
subject inventions or reportable items, all such technologies are
evaluated for publication in NASA Tech Briefs magazine. If an item is
published in NASA Tech Briefs, the innovator may be considered for a
monetary award from NASA. Innovations meeting eligibility requirements
may also be considered for additional Space Act Awards
([http://icb.nasa.gov](http://icb.nasa.gov/)).

I.  **General Information**

1\. Type of Report: Interim Final Reporting Period (Begin/End Dates):
  /  /       /  /    

2\. Business Type: Large Small College/University Nonprofit Organization

2.  

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3.  Have any New Technology Items resulted from work performed under
    this Funding Agreement during this reporting period? Yes No

> 3a. If Yes, were they disclosed to NASA? Yes No

Note: If they have not yet been disclosed, they can be disclosed with
this Summary Report (See I.4.).

4\. Are New Technology Items being disclosed with this Summary Report?
Yes No

> (Use NASA Form 1679 or equivalent -- see
> [http://invention.nasa.gov](http://invention.nasa.gov/) for access to
> form or on-line reporting).

II. **New Technology Items**

Please provide the following information for all New Technology Items
reportable under this Funding Agreement during the reporting period. If
additional space is required, include an attachment.

**[Title]{.underline} [Internal Report/Docket]{.underline} [Date
Submitted.]{.underline}**

**[Number (if applicable)]{.underline} [to NASA]{.underline}**

1\.               /  /    

2\.               /  /    

3\.               /  /    

4\.               /  /    

III. **Subcontractors**

Please complete the following section listing all research
subcontractors participating to date. Include each research
subcontractor's name, address, contact person, telephone number and
email address. [Note:]{.underline} If subcontractors have New Technology
Items to disclose, they should follow the same reporting process as
prime participants.

IV. **Certification**

***I certify that active and effective procedures ensuring prompt
identification and timely disclosures of reportable New Technology Items
have been followed. Furthermore, I certify that all New Technology Items
required to be disclosed during the period identified on this form have
been disclosed to NASA or are being submitted herewith.***

     

**Name and Title of Authorized Official**

  /  /    

**Signature** **Date**

Please submit completed NASA New Technology Summary Reports and/or
Disclosures of Invention and New Technologies to the NASA Center funding
the activity (see attached listing).

Note: If an individual Disclosure of Invention and New Technology is
submitted using the on-line reporting tool, it is not necessary to
follow up with a hard copy submission.