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Joint Applicants—Statement of Respective Contributions

The parties to this statement are Joint Applicants (JAs) to the invention or patent application entitled: “_________________________________________________________________.”
We understand that a patent application should be filed in the names of all persons who contributed to at least one claim and that any person who did not contribute to at least one claim should not be named as a JA.
We also recognize and agree that if the patent claims in any patent application based on the invention are altered so that the listing of any JA is inappropriate, that JA should be removed from the patent application.
In order to keep the contributions of the JAs in order and preserve them, we hereby record each JA’s contributions as follows:

Joint Applicants
Print Name: _________________________________	Date: __________________
Signature: __________________________________
Contributions: ____________________________________________________________ ________________________________________________________________________ ________________________________________________________________________

Print Name: _________________________________	Date: __________________
Signature: __________________________________
Contributions: ____________________________________________________________ ________________________________________________________________________ ________________________________________________________________________

www.nolo.com 	Form 16-1: Joint Applicants—Statement of Respective Contributions		Page  of