RICHARD A. RYAN

                                INVENTION DISCLOSURE FORM
                  (USE CONTINUATION SHEETS AS NECESSARY)


1. Inventor(s) - Full name (including middle initial), address and phone number and Nationality (i.e.,
U.S.A.):
       __________________________________________________________________
        __________________________________________________________________  
        __________________________________________________________________
        __________________________________________________________________
                                                                                              

2. Will this Invention be assigned to a company or another entity?
( )Yes  ( )No
        If yes, Name of entity:___________________________________________
                      Type of entity (corp., partnership, etc.):_______________________
                      State of incorporation, partnership, etc.: ______________________
                      Address for entity: ______________________________________
                                                      ____________________________________
                     
3. Title of Invention:  ________________________________________________________
                             ________________________________________________________        
                                                               
                                                                                         
4. Date when invention first thought of: __________________________________________       
     Is this date documented in writing? ( )Yes  ( )No.  

5. Has a working model been made? ( )Yes  ( )No.  
             If so, when?  _____________________________________________________          
                             
6. Has the invention been:
a. Offered for sale or sold? ( )Yes ( )No  When?  _________________________________   
b. Described in a Publication? ( )Yes ( )No  When?  _______________________________
c. Publicly used/demonstrated? ( )Yes ( )No  When?  ______________________________

7. Background of the invention:
a. What is the problem solved by the invention?                         
      __________________________________________________________________
      __________________________________________________________________  
      __________________________________________________________________
      __________________________________________________________________
                                                                                                       
b. How was problem solved before the invention?                         
       __________________________________________________________________  
       __________________________________________________________________
       __________________________________________________________________

c. Why does the invention solve the problem better?                 
       __________________________________________________________________  
       __________________________________________________________________
       __________________________________________________________________

d. List or describe the closest related patents, publications
      or products known.                                                                         
       __________________________________________________________________  
       __________________________________________________________________
       __________________________________________________________________

8. Describe the invention in detail:
a. What are its basic components?                                                 
       __________________________________________________________________  
       __________________________________________________________________
       __________________________________________________________________

b. Which components are essential and why?                                 
       __________________________________________________________________  
       __________________________________________________________________
       __________________________________________________________________

c. How are the components connected or organized?                                                                      
        __________________________________________________________________  
       __________________________________________________________________
       __________________________________________________________________

d. How does it operate (function or steps)?                                 
        __________________________________________________________________  
        __________________________________________________________________
        __________________________________________________________________

e. How does someone use the invention?                                         
       __________________________________________________________________  
       __________________________________________________________________
       __________________________________________________________________

f. How does the invention accomplish its objectives?                 
       __________________________________________________________________  
       __________________________________________________________________
       __________________________________________________________________
                                                                                                     
g. What limitations exist (i.e., temperature, quantities, sizes
  or materials)?                                                                         
       __________________________________________________________________  
       __________________________________________________________________
       __________________________________________________________________

9. What variations (i.e., materials, components or functions) to
        your invention are currently known?                                         
       __________________________________________________________________  
       __________________________________________________________________
       __________________________________________________________________
       __________________________________________________________________  
       __________________________________________________________________
       __________________________________________________________________
                                                                                                    

10.  Additional pages attached:
     a. ____ pages of continuation sheets for items above.
     b. ____ pages of drawings, sketches, photographs and/or
                documentary evidence of date of invention.


                                             INVENTION DISCLOSURE FORM
                                                    CONTINUATION SHEET

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ATTORNEY AT LAW