DA Form 2872-r "Request for Determination of Invention Rights"

What Is DA Form 2872-r?

This is a military form that was released by the U.S. Department of the Army (DA) on April 1, 1993. The form, often mistakenly referred to as the DD Form 2872-r, is a military form used by and within the U.S. Army. As of today, no separate instructions for the form are provided by the DA.

Form Details:

  • A 1-page document available for download in PDF;
  • The latest version available from the Army Publishing Directorate;
  • Editable, free, and easy to use;

Download an up-to-date fillable DA Form 2872-r down below in PDF format or browse hundreds of other DA Forms stored in our online database.

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Download DA Form 2872-r "Request for Determination of Invention Rights"

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GPB CASE NO. 10 -
REQUEST FOR DETERMINATION OF INVENTION RIGHTS
For use of this form, see AR 27-60; the proponent agency is OTJAG
1. TO
2. FROM
3. NAME OF INVENTOR
4. DATE
5. TITLE OF INVENTION
6. DESCRIPTION OF INVENTION
7. PATENT APPLICATION NUMBER
8. DATE APPLICATION WAS FILED
9. EXISTING GOVERNMENT RIGHTS
10. EMPLOYMENT STATUS OF INVENTOR (Title, grade,
office, installation)
EXECUTED LICENSE FOR GOVERNMENT FILING OF
PATENT APPLICATION
OTHER INSTRUMENT EXECUTED (Specify below)
11. RECOMMENDATION
THE INFORMATION BELOW IS TO BE COMPLETED BY THE INTELLECTUAL PROPERTY DIVISION (OTJAG)
12. DEPARTMENT OF THE ARMY DETERMINATION
13. TYPED NAME AND TITLE
14.SIGNATURE
15. DATE
DA FORM 2872-R, APR 1993
REPLACES DA FORM 2872-R, JUN 66, WIHICH IS OBSOLETE
APD LC v2.01ES
GPB CASE NO. 10 -
REQUEST FOR DETERMINATION OF INVENTION RIGHTS
For use of this form, see AR 27-60; the proponent agency is OTJAG
1. TO
2. FROM
3. NAME OF INVENTOR
4. DATE
5. TITLE OF INVENTION
6. DESCRIPTION OF INVENTION
7. PATENT APPLICATION NUMBER
8. DATE APPLICATION WAS FILED
9. EXISTING GOVERNMENT RIGHTS
10. EMPLOYMENT STATUS OF INVENTOR (Title, grade,
office, installation)
EXECUTED LICENSE FOR GOVERNMENT FILING OF
PATENT APPLICATION
OTHER INSTRUMENT EXECUTED (Specify below)
11. RECOMMENDATION
THE INFORMATION BELOW IS TO BE COMPLETED BY THE INTELLECTUAL PROPERTY DIVISION (OTJAG)
12. DEPARTMENT OF THE ARMY DETERMINATION
13. TYPED NAME AND TITLE
14.SIGNATURE
15. DATE
DA FORM 2872-R, APR 1993
REPLACES DA FORM 2872-R, JUN 66, WIHICH IS OBSOLETE
APD LC v2.01ES