Copyright Procedure 09182019

Republic of the Philippines
POLYTECHNIC UNIVERSITY OF THE PHILIPPINES

OFFICE of the VICE PRESIDENT for RESEARCH, EXTENSION and DEVELOPMENT
INNOVATION AND TECHNOLOGY SUPPORT OFFICE
Copyright Procedure
1. Fill-out all the Copyright Application forms and Affidavit of Co-ownership in triplicate copy (3) duly signed by the
author/s and have it notarized.
2. Fill-out the recordal slip and acknowledgement receipt.
3. Pay the amount of Two Hundred Fifty Pesos (PHP 250.00) at the Cashiers’ Window 1. Secure the Receipt.
4. Submit to IPMO-ITSO-CTTED Office.
Requirements
For Main Campus:
 In your college color coding envelope with label at the back of the envelope.
(College, Program, Title, Author/s, Adviser)
 Triplicate (3) copy of Copyright Application forms and Affidavit of Co-ownership with
signature/s of author/s and duly notarized.
 1 copy of Approval Sheet with complete signature/s.
 Original receipt of payment
 Recordal slip and acknowledgement receipt
 3 copies of manuscript/thesis/dissertation in Journal Publication Format in CD form with CD
case and label.
For Branches and Campuses:
 Brown envelope with label at the back of the envelope.
(College, Program, Title, Author/s, Adviser)
 Triplicate (3) copy of Copyright Application forms and Affidavit of Co-ownership with
signature/s of author/s and duly notarized.
 1 copy of Approval Sheet with complete signature/s.
 Original receipt of payment
 Recordal slip and acknowledgement receipt
 3 copies of manuscript/thesis/dissertation in Journal Publication Format in CD form with CD
case and label.
4TH Floor South Wing, PUP A. Mabini Campus, Anonas Street, Sta. Mesa, Manila 1016
Trunk Line: 335-1787 or 335-1777 local 234
Website: www.pup.edu.ph | Email: [email protected]
THE COUNTRY’S 1st POLYTECHNICU ISO 9001:2015 CERTIFIED

CERTIFICATE NUMBER: AJA18-0190
JOURNAL PUBLICATION FORMAT
Times New Roman 14 font size Centered and Bold

The title should not be more than fifteen words
First Name Last Name (Surname) 1, First Name Last Name (Surname) 2 and First Name Last name (Surname) 3
1
Department/Research Institute, University, Country (Corresponding author)
2
Department/Research Institute, University, Country
3
Department/Research Institute, University, Country (Thesis adviser)
ABSTRACT
Abstract must have a maximum of 200 to 250 word only
I. INTRODUCTION
The introduction should be simple and graspable to colleagues from other fields also. Please mention the novelty of the work,
purpose/objective/s and possible application in the introduction. References must be added in the text with superscripts 1.
II. EXPERIMENTAL METHOD/S
The specific techniques or procedure used in conducting this study can be explained briefly here. Describe the method used;
participants (sample and sampling techniques) or source of data; research instrument/s or apparatuses used; data gathering procedures;
and analysis of data (i.e., statistical tools, if quantitative). Subheadings can be used to differentiate the different methods in this
section.
III. RESULTS AND DISCUSSION
In this section, try to present the data as concisely and clearly as possible. Figures, Tables and Scheme can be included. Example Fig.
1, Table 1, Scheme 1 etc.
There should be sufficient information for the reader to understand, but it is not necessary to write an extensive text to explain all the
detail.
a b c
 = 0
Graphite sheet (Current collector)
230x 43.4 μm
Fig. 1 - SEM (230x magnification) micrographs of the activated charcoal electrode (a) surface, (b) cross-section and (c) contact angle
image
Discussion should summarize the observations and attempts to place this data into the context of the existing body of literature to
express opinions about the significance of the work.
IV. CONCLUSION
This short section is to summarize the work based on the facts in evidence and point out the main areas covered in the writing. It may
also contain the future directions of the work.
V. REFERENCES
References must be numbered. Keep the same style.
1. G. L. Andres et. al, A capacitive deionization system with high energy recovery and effective reuse, Energy 103, 605-617 (2016)
ACKNOWLEDGMENTS
Authors can acknowledge any person, or funding agency that has made a significant contribution to the work.
*Appendices/Supplementary Data - may be included as supporting documents. This may contain tables, graphs, full or extract of the
research questionnaires, details/pictures of apparatuses use, mathematical proofs, and other important details that may distract the
reader when presented in the main body of your paper.
*Author/s note - this contains the following information which may already be shown/footnoted in the first page of the manuscript (1)
author/s full name and affiliation/s (2) email address, permanent house address.

Deed of Assignment for Application of Patent/UM/Industrial Design/Trademark
KNOW ALL MEN BY THESE PRESENTS:
This ASSIGNMENT OF APPLICATION FOR PATENT/UM/INDUSTRIAL /DESIGN/TRADEMARK
___________________________________________________________________________________________________
(Title of Invention/UM/Industrial Design/Trademark)
Execute by:
Name of Author/s Contact Details Signature
______________________________ _________________________________________ ________________
_______________________________ __________________________________________ _________________
_______________________________ ___________________________________________ ________________
_______________________________ ____________________________________________ ________________
_______________________________ ____________________________________________ ________________
*Corresponding Author: Name of Representative:_________________________ (Representative to all the authors and have
the authority to do and perform all and every act in whatsoever requisite, necessary and proper to be done in the premises as fully to all
intents and purposes and it might or could lawfully do if personal present )
(Name of IPMO Director/ ITSO Chief
[Name of Assignee(s))
Of PUP-ITSO Southwing rm 403, Mabini Campus Sta. Mesa , Manila

[Address(es) of Assignee(s)]
That the ASSIGNEE(S) by virtue hereof, does/do hereby appoint
( Name of IPMO Director and or ITSO Chief)
of ITSO - PUP Southwing rm. 403 Mabini Campus, Anonas Street Sta. Mesa, Manila
To file applications for Invention Patents, Industrial Design and Utility Model Patents; to progress pending applications for invention
patent, industrial design or utility model patents; to receive the Certificate of Registrations/Letters Patent and upon whom may be
served notices and processes relating to the above mentioned applications.
ACKNOWLEDGEMENT
_____________________): S.S.
_____________________)
BEFORE ME, Notary Public for and in _______________________________________________________
________________________________________________________________________________________________
personally appeared: ______________________________________________________________________________

________________________________________________________________________________________________
known to me to be same persons who execute the foregoing instrument, and they acknowledged to me that the same is
their free act and deed.

IN WITNESS WHEREOF, I have hereunto set my hand and affixed my notarial seal this _______________day
________________, 20_____, at ______________________________________, Philippines.
NOTARY PUBLIC
Doc. No. ___________________;

Page No. ___________________;
Book No. ___________________;
Series of ___________________;

Please use the following websites to conduct your preliminary search report:
(For Patent/UM Application)

OFFICE WEBSITE SPECIFIC URL
World Intellectual www.wipo.int https://patentscope.wipo.int/search/en/result.jsf

Property Organization
US Patent Office www.uspto.gov http://www.uspto.gov/patents-application-process/search-patents
Google Patents https://patents.google.com/
European Patent Office www.espacenet.com https://worldwide.espacenet.com/advancedSearch?locale=en_EP
IPO Philippines www.ipophil.gov.ph http://onlineservices.ipophil.gov.ph/ipophilsearch/patentsearch.aspx
SPECIFIC URL
https://patentscope.wipo.int/search/en/result.jsf
http://www.uspto.gov/patents-application-process/search-patents
https://patents.google.com/
https://worldwide.espacenet.com/advancedSearch?locale=en_EP
http://onlineservices.ipophil.gov.ph/ipophilsearch/patentsearch.aspx
PUP-ACRE-4-IPMO-001
4TH Floor South Wing, PUP A. Mabini Campus, Anonas Street, Sta. Mesa, Manila 1016 Rev. 0
May 15, 2018


Office of the Vice President for Research, Extension, and Development
INTELLECTUAL PROPERTY MANAGEMENT OFFICE
Sta. Mesa, Manila
Date: ______________
ACKNOWLEDGMENT RECEIPT
Received the thesis/dissertation/manuscript of
entitle
For transmittal at the National Library of the Philippines for copyright registration.
Signature (IPMO-ITSO-CTTED Staff)
Republic of the Philippines PUP-RECO-4-IPMO-002

Rev. 0
POLYTECHNIC UNIVERSITY OF THE PHILIPPINES May 15, 2018
Office of the Vice President for Research, Extension, and Development

INTELLECTUAL PROPERTY MANAGEMENT OFFICE
Sta. Mesa, Manila
RECORDAL
BRANCH/CAMPUS:___________________________COLLEGE & Program: _______________ ____
TITLE:_______________________________________________________________________________ _
_________________________________________________________________________________ _____
AUTHOR/S:__________________________________________________________________________ __
CLASSIFICATION:______________________________________________________________ _______
CONTACTNUMBER:___________________________________EMAIL:______________________ _____

For CD Case Label

INVENTION DISCLOSURE FORM
1. Title of Invention: _______________________________________________________

The title must be specific. It should clearly and concisely state the technical designation on the
invention and avoid all fancy terms, which do not describe the technical features of its invention
(Per Rule 410 of IPO’s Manual for Substantive Examination Procedure).
2. Corresponding Authors (as needed, separate sheet may be used but follow same format)
Name:
Address:
E-mail:
Cellphone No.:
Fax No.;
3. Invention Category (please check). (Per Rule 201, IPO’s Rules and Regulation on Inventions)
____ a useful machine
____ a product
____ a process
____ an improvement of any of the foregoing
____ microorganism
____ non-biological and microbiological process
4. Disclosure and Technical Description of the Invention.
The application shall disclose the invention in a manner sufficiently clear and complete for it to be
carried out by a person skilled in the art (Per Rule 405 IPO’s Rules and Regulations on Invention).
 If the invention is a machine, the technical description must be in conjunction with the accompanying
drawings/sketches. Provide a clear description of:
a) the positive structural relationships of the essential elements (component parts) of your device by
which it could perform the desired function; and
b) the manner and process of making, constructing and compounding and using the machine.
 If the invention is a chemical or food products or process, please provide the following:
a) the description of the step by step procedure on how to formulate the product and the conditions
being observed in each step;

b) the chemical compositions (ingredients or raw materials used to produce the product) in percent weight or
volume; and (
c) the concentrations of the reagents used.
Please also provide information covering the following (Please use separate sheet).
 Purpose/objective of the invention;

 Improvements and advantages over existing similar inventions (please cite specific references); and
 Potential commercial application of the invention.
5. Status of Development
____ Concept only ____ Laboratory tested
____ With prototype ____ Others (please specify)
6. Publication/Public Disclosure
Has the invention/utility model been described in any publication or discussed in seminars, for a,
public demonstration and similar activities? _____ If so, where and when? Please provide details.
7. Sale
Has the invention been offered for sale to the public or has sale ever been made? ______
If so, where and when? Please provide details. __________________________
_______________________________________________________________________
8. Funding of the Invention

Source of funds for the development of the event
____ personal
____ government funding
____ other entity
The inventors further certify that:
1. The above invention is our own work and not copied from others;
2. All names appearing in the list above and below are true and actual inventors for said invention; and
3. All inventors of said invention are listed with nobody being excluded.
INVENTOR/S SIGNATURE/S
_____________________________ ____________________________
_____________________________ ____________________________
_____________________________ ____________________________

PRELIMINARY SEARCH REPORT
TITLE:
FIELD OF
SPECIALIZATION:
SHORT DESCRIPTION:
AGENCY:
INVENTORS:
KEYWORDS USED:
Please use the following websites to conduct your preliminary search report:
OFFICE WEBSITE SPECIFIC URL
World Intellectual Property www.wipo.int https://patentscope.wipo.int/search/en/result.jsf

Organization
US Patent Office www.uspto.gov http://www.uspto.gov/patents-application-process/search-patents
Google Patents https://patents.google.com/
European Patent Office www.espacenet.com https://worldwide.espacenet.com/advancedSearch?locale=en_EP
IPO Philippines www.ipophil.gov.ph http://onlineservices.ipophil.gov.ph/ipophilsearch/patentsearch.aspx

RESULTS OF PRELIMINARY SEARCH:
SPECIFIC URL Keywords Used No. Of Hits Similar Technologies
https://patentsc
ope.wipo.int/sea
rch/en/result.jsf
http://www.uspt
o.gov/patents-
application-
process/search-
patents
https://patents.g
oogle.com/
https://worldwid
e.espacenet.co
m/advancedSea
rch?locale=en_
EP
http://onlineserv
ices.ipophil.gov.
ph/ipophilsearc
h/patentsearch.
aspx
Please discuss the difference of your technology to the similar prior art you have searched (you may use other sheets of paper):
______________________________________________________________________________________________
______________________________________________________________________________________________


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Republic of the Philippines

POLYTECHNIC UNIVERSITY OF THE PHILIPPINES

THE COUNTRY’S 1st POLYTECHNICU ISO 9001:2015 CERTIFIED

JOURNAL PUBLICATION FORMAT

Times New Roman 14 font size Centered and Bold

THE COUNTRY’S 1st POLYTECHNICU ISO 9001:2015 CERTIFIED

Deed of Assignment for Application of Patent/UM/Industrial Design/Trademark

KNOW ALL MEN BY THESE PRESENTS:

This ASSIGNMENT OF APPLICATION FOR PATENT/UM/INDUSTRIAL /DESIGN/TRADEMARK

Name of Author/s Contact Details Signature

______________________________ _________________________________________ ________________

_______________________________ __________________________________________ _________________

_______________________________ ___________________________________________ ________________

_______________________________ ____________________________________________ ________________

_______________________________ ____________________________________________ ________________

(Name of IPMO Director/ ITSO Chief

Of PUP-ITSO Southwing rm 403, Mabini Campus Sta. Mesa , Manila

That the ASSIGNEE(S) by virtue hereof, does/do hereby appoint

( Name of IPMO Director and or ITSO Chief)

BEFORE ME, Notary Public for and in _______________________________________________________

personally appeared: ______________________________________________________________________________

THE COUNTRY’S 1st POLYTECHNICU ISO 9001:2015 CERTIFIED

Doc. No. ___________________;

THE COUNTRY’S 1st POLYTECHNICU ISO 9001:2015 CERTIFIED

(For Patent/UM Application)

World Intellectual www.wipo.int https://patentscope.wipo.int/search/en/result.jsf

US Patent Office www.uspto.gov http://www.uspto.gov/patents-application-process/search-patents

Google Patents https://patents.google.com/

European Patent Office www.espacenet.com https://worldwide.espacenet.com/advancedSearch?locale=en_EP

IPO Philippines www.ipophil.gov.ph http://onlineservices.ipophil.gov.ph/ipophilsearch/patentsearch.aspx

THE COUNTRY’S 1st POLYTECHNICU ISO 9001:2015 CERTIFIED

Republic of the Philippines

Received the thesis/dissertation/manuscript of

Signature (IPMO-ITSO-CTTED Staff)

Republic of the Philippines PUP-RECO-4-IPMO-002

POLYTECHNIC UNIVERSITY OF THE PHILIPPINES May 15, 2018

Office of the Vice President for Research, Extension, and Development

BRANCH/CAMPUS:___________________________COLLEGE & Program: _______________ ____

THE COUNTRY’S 1st POLYTECHNICU ISO 9001:2015 CERTIFIED

For CD Case Label

THE COUNTRY’S 1st POLYTECHNICU ISO 9001:2015 CERTIFIED

INVENTION DISCLOSURE FORM

1. Title of Invention: _______________________________________________________

____ an improvement of any of the foregoing

____ non-biological and microbiological process

4. Disclosure and Technical Description of the Invention.

THE COUNTRY’S 1st POLYTECHNICU ISO 9001:2015 CERTIFIED

 Purpose/objective of the invention;

____ With prototype ____ Others (please specify)

If so, where and when? Please provide details. __________________________

8. Funding of the Invention

____ government funding

____ other entity

The inventors further certify that:

THE COUNTRY’S 1st POLYTECHNICU ISO 9001:2015 CERTIFIED

PRELIMINARY SEARCH REPORT

OFFICE WEBSITE SPECIFIC URL

World Intellectual Property www.wipo.int https://patentscope.wipo.int/search/en/result.jsf

US Patent Office www.uspto.gov http://www.uspto.gov/patents-application-process/search-patents

______ _

_____ _

_____ _

___

___

BRANCH/CAMPUS:_________________COLLEGE & Program: _

With prototype Others (please specify)