C. Entity Interest in Outcome. If, to your knowledge, the entity is interested in the outcome of your research or academic work, but is not a sponsor of your work, explain why the entity has such interest, in your opinion. D. Gifts or Grants. If the entity has made gifts or grants to UM or the University of Maryland Foundation (UM Fund) in support of your work at UM, give information about the dates and amounts of the gifts or grants, including whether or not the funds were used for any purpose related to your proposed relationship with the entity. Section Five. Ownership Information. If you are requesting an exemption permitting you to have an ownership interest in an entity, provide the requested information, and attach a copy of any written proposal or offer covering the ownership interest. A. What "units" you will or may own. (E.g., stock, warrants, limited partnership interest, LLC interest.) B. Ownership. _______ ______ Individual Joint _______________________________ If joint, name of co-owner: C. Value of your Ownership Interest. Current estimated dollar value ________________. ____________. Percent of total ownership D. Conditions of Ownership. Describe any conditions or encumbrances affecting your ownership interest. (E.g., will you be prohibited from exercising options or selling stock for a certain period of time, or until certain events occur?)
C. Entity Interest in Outcome. If, to your knowledge, the entity is interested in the outcome of your research or academic work, but is not a sponsor of your work, explain why the entity has such interest, in your opinion. D. Gifts or Grants. If the entity has made gifts or grants to UM or the University of Maryland Foundation (UM Fund) in support of your work at UM, give information about the dates and amounts of the gifts or grants, including whether or not the funds were used for any purpose related to your proposed relationship with the entity. Section Five. Ownership Information. If you are requesting an exemption permitting you to have an ownership interest in an entity, provide the requested information, and attach a copy of any written proposal or offer covering the ownership interest. A. What "units" you will or may own. (E.g., stock, warrants, limited partnership interest, LLC interest.) B. Ownership. Individual _______ Joint ______ If joint, name of co-owner: _______________________________ C. Value of your Ownership Interest. Current estimated dollar value ________________. Percent of total ownership ____________. D. Conditions of Ownership. Describe any conditions or encumbrances affecting your ownership interest. (E.g., will you be prohibited from exercising options or selling stock for a certain period of time, or until certain events occur?)
coi_form_nonsom.docx