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9102 215-854-6427 (tel) 215-569-0216 (fax) www.madaypatentlaw.com Invention Disclosure Form Date submitted: Title: CONTRIBUTOR/INVENTOR(S) - Preliminary list of people who may have contributed to the conception of the invention: PURPOSE OF INVENTION - What are the primary objectives of the invention? BACKGROUND and PRIOR ART What problems or shortcomings with current technology served to as motivation for your i.

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