PLEASE SEND DEVELOPMENT REPORTS TO. University of Florida Research Foundation, Inc. Attn: Director 000 Xxxxxx Xxxx P.O. Box 115500 Gainesville, FL 32611-5500 Facsimile: [***] [***] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions. Appendix C
PLEASE SEND DEVELOPMENT REPORTS TO. Wisconsin Alumni Research Foundation Attn.: Contracts Manager 000 Xxxxxx Xxxxxx, 00xx Xxxxx Xxxxxxx, XX 00000
PLEASE SEND DEVELOPMENT REPORTS TO. University of Florida Research Foundation, Inc. Attn: Director 000 Xxxxxx Xxxx P.O. Box 115500 Gainesville, FL 32611-5500 Facsimile: 000-000-0000 *** Confidential Treatment Requested
PLEASE SEND DEVELOPMENT REPORTS TO. University of Florida Research Foundation, Inc. Attn: Director 000 Xxxxxx Xxxx P.O. Box 115500 Gainesville, FL 32611-5500 Facsimile: 000-000-0000 Appendix C UFRF Royalty Report Licensee: Agreement No.: Inventor: P#: P Period Covered: From: / /2 Through: / /2 Prepared By Date: Approved By: Date: If license covers several major product lines, please prepare a separate report for each line. Then combine all product lines into a summary report.
PLEASE SEND DEVELOPMENT REPORTS TO. University of Florida Research Foundation, Inc. Attn: Director 000 Xxxxxx Xxxx P.O. Box 115500 Gainesville, FL 32611-5500 Facsimile: 000-000-0000 *** Confidential Treatment Requested Appendix C — UFRF Royalty Report Licensee:__________________________ Agreement No: ______________________ Inventor:__________________________ P#: _______________________________ Period Covered: From: ___________ Through:___________ Prepared By________________________ Date:______________________________ Approved By:_______________________ Date: ______________________________ If license covers several major product lines, please prepare a separate report for each line. Then combine all product lines into a summary report. Report Type: o Single Product Line Report:______________________ o Multiproduct Summary Report. Page 1 of ________ Pages o Product Line Detail. Line:______ Tradename:______ Page:_____ Report Currency: o U.S. Dollars o Other______________________ Period Royalty Amount Unit Gross * Less: Net Royalty Country Sales $$ Sales Allowances $$ Sales Rate This Year Last Year U.S.A. Canada Europe Japan Other:
PLEASE SEND DEVELOPMENT REPORTS TO. USF Division of Patents & Licensing Attn: Associate Vice President 3000 Xxxxxxxx Xxxx, Xxxxx 000 Xxxxx, Xxxxxxx 00000 Appendix C - Licensor Royalty Report Licensee: Agreement No.: Inventor: Technology#: Period Covered: From: / /2 Through: / /2 Prepared By: Date: Approved By: Date: If license covers several major product lines, please prepare a separate report for each line. Then combine all product lines into a summary report.
PLEASE SEND DEVELOPMENT REPORTS TO with a copy to: President Office of Commercialization Florida State University Research Foundation, Inc. Florida State University Attn: Xxxx X. Xxxxxxxxx Attn: Executive Director 0000 Xxxx Xxxxxx, Suite 000 00 Xxxxxxxx Xxx, 000 Xxxxxxx Xxxx. Tallahassee, FL 00000 Xxxxxxxxxxx, XX 00000-4391 Facsimile Number: (000) 000-0000 Facsimile Number: (000) 000-0000
PLEASE SEND DEVELOPMENT REPORTS TO. University of Florida Research Foundation, Inc. Attn: Director 000 Xxxxxx Xxxx P.O. Box 115500 Gainesville, FL 32611-5500 Facsimile: 000-000-0000 *** Confidential Treatment Requested Appendix C — UFRF Royalty Report Licensee: Agreement No: Inventor: P#: Period Covered: From: Through: Prepared By Date: Approved By: Date: If license covers several major product lines, please prepare a separate report for each line. Then combine all product lines into a summary report. Report Type: o Single Product Line Report: o Multiproduct Summary Report. Page 1 of ________ Pages o Product Line Detail. Line:______ Tradename:______ Page:_____ Report Currency: o U.S. Dollars o Other Unit Gross * Less: Net Royalty Period Royalty Amount Country Sales $$ Sales Allowances $$ Sales Rate This Year Last Year U.S.A. Canada Europe Japan Other: TOTAL: Total Royalty: Conversion Rate: Royalty in U.S. Dollars: $ The following royalty forecast in non-binding and for UFRF’s internal planning purposes only: Royalty Forecast Under This Agreement: Next Quarter:_____ Q2:_____ Q3:_____ Q4:_____ *On a separate page, please indicate the reasons for returns or other adjustments if significant. Also note any unusual occurrences that affected royalty amounts during this period. To assist UFRF’s forecasting, please comment on any significant expected trends in sales volume. *** Confidential Treatment Requested
PLEASE SEND DEVELOPMENT REPORTS TO. Washington State University Office of Commercialization Attn: Assistant Vice President Xxxxxx 280/286 XX Xxx 000000 Xxxxxxx XX 00000 APPENDIX C WSU ROYALTY REPORT Licensee: Agreement No.: Inventor: P#: P Period Covered: From: / / Through: / / Prepared By: Date: Approved By: Date: If license covers several major product lines, please prepare a separate report for each line. Then combine all product lines into a summary report.
PLEASE SEND DEVELOPMENT REPORTS TO. USF Division of Patents & Licensing Attn: Assistant Vice President 0000 Xxxxxxxx Xxxx, Xxxxx 000 Xxxxx, Xxxxxxx 00000 Initials /s/ VLM MP1735585.1 Confidential Treatment-Redacted Copy CONFIDENTIAL PORTIONS OF THIS AGREEMENT HAVE BEEN OMITTED AND FILED SEPARATELY WITH THE SECURITIES AND EXCHANGE COMMISSION UNDER A CONFIDENTIAL TREATMENT REQUEST, PURSUANT TO RULE 406 OF THE SECURITIES ACT OF 1933, AS AMENDED, AND RULE 24b-2 OF THE SECURITIES EXCHANGE ACT OF 1934, AS AMENDED. THE REDACTED TERMS HAVE BEEN MARKED IN THIS EXHIBIT AT THE APPROPRIATE PLACE WITH FOUR ASTERISKS [****]. Appendix C - Licensor Royalty Report Licensee: Agreement No.: Inventor: P#: P Period Covered: From: / /2 Through: / /2 Prepared By Date: Approved By: Date: If license covers several major product lines, please prepare a separate report for each line. Then combine all product lines into a summary report. Report Type: ¨ Single Product Line Report: ¨ Multiproduct Summary Report. Page 1 of ______ Pages ¨ Product Line Detail. Line: Tradename: Page: Report Currency: ¨ U. S. Dollars ¨ Other Unit Gross * Less: Net Royalty Period Royalty Amount Country Sales $$ Sales Allowances $$ Sales Rate This Year Last Year U.S.A. Canada Europe: Japan Other: TOTAL: Initials /s/ VLM MP1735585.1 Confidential Treatment-Redacted Copy CONFIDENTIAL PORTIONS OF THIS AGREEMENT HAVE BEEN OMITTED AND FILED SEPARATELY WITH THE SECURITIES AND EXCHANGE COMMISSION UNDER A CONFIDENTIAL TREATMENT REQUEST, PURSUANT TO RULE 406 OF THE SECURITIES ACT OF 1933, AS AMENDED, AND RULE 24b-2 OF THE SECURITIES EXCHANGE ACT OF 1934, AS AMENDED. THE REDACTED TERMS HAVE BEEN MARKED IN THIS EXHIBIT AT THE APPROPRIATE PLACE WITH FOUR ASTERISKS [****]. Total Royalty: _______________ Conversion Rate: ____________ Royalty in U.S. Dollars: $ The following royalty forecast is non-binding and for Licensor’s internal planning purposes only: Royalty Forecast Under This Agreement: Next Quarter:__________ Q2:__________ Q3:__________ Q4:__________ * On a separate page, please indicate the reasons for returns or other adjustments if significant. Also note any unusual occurrences that affected royalty amounts during this period. To assist Licensor’s forecasting, please comment on any significant expected trends in sales volume.
