Nevada Inventors Association P O. Box 11008 Reno, NV 89510 Phone (775) 322-9636 Fax (775) 322-0147 http://www.nevadainventors.org www.doncostar.com Email address: costar@attglobal.net

picture or description of Disclosed Item

NOTE: It is important that the confidential disclosure document be on one page (one sheet of paper). Place the following on the bottom of the page, after a simple sketch and brief description of your invention is placed above the signatures. The witness must be someone who would NOT benefit by your, or your invention's, success.

top of page pictures and words of the invention.

Inventors name                                   READ AND UNDERSTOOD BY:


________________________________       ________________________________
         Signature of Inventor               Signature of Witness

________________________________       ________________________________
         Date Signed                             Date Signed

________________________________       ________________________________
         Print Name of Inventor              Print Name of Witness

________________________________       ________________________________
         Street or P.O. Box No.              Street or P.O. Box No.

________________________________       ________________________________
         City, State & Zip Code              City, State & Zip Code

________________________________       ________________________________
         Phone Number                            Phone Number

We have 3 Downloadable forms of the inventors Disclosure form
click on a button and save file to disk, then later open application for that file and see form. remember that this form is for the bottom of each page.

The first is a TEXT form
The second is a RTF form
The third is a Word Perfect form

To go to the mainPage or the news letters .

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Page done by Vince Chemist.
Started on Febuary 12 2002
Updated on July 02 2004