LICENSOR: [Name] LICENSEE: [Company name] By By [Name] [Name] [Title] Date Date EXHIBIT A TO PATENT LICENSE AGREEMENT PATENT RIGHTS Jointly Owned? (Y/N; if Y, App. No./ with Date of Filing Inventor(s) whom?) Prosecution Counsel [App [Title of patent] [Inventor name(s)] Yes, [Law firm] number] w/[whom] [Filing date] No [App [Title of patent] [Inventor name(s)] Yes, [Law firm] number] w/[whom] [Filing date] No USPTO Entity Status as of one box: Effective Date Small Large
LICENSOR: [Name] By [Name] Date LICENSEE: [Company name] By [Name] [Title] Date EXHIBIT A TO PATENT LICENSE AGREEMENT PATENT RIGHTS App. No./ Date of Filing Inventor(s) Jointly Owned? (Y/N; if Y, with whom?) Prosecution Counsel [App number] [Filing date] [Title of patent] [Inventor name(s)] Yes, w/[whom] No [Law firm] [App number] [Filing date] [Title of patent] [Inventor name(s)] Yes, w/[whom] No [Law firm] USPTO Entity Status as of Effective Date one box: Small Large
patent-license-agreement-lifesci-template-all-one2010-03-01.docx