Standards Procedure Toolbox

(Blank) IPR Statement Forms 

09-03-2021 10:09

For use by companies wishing to disclose when they have a patent referenced in a TIA standard.
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  • Patent Holder Statement - General
  • Patent Holder Statement - Specific
  • Software Copyright Holder Statement

Once completed - Please send the completed form and Exhibit A (PDF or MS Word Document) to IPR@tiaonline.org.

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pdf file
071323_IPR Statement_Software.pdf   124 KB   1 version
Uploaded - 03-23-2026
pdf file
071823_Patent Holder Statement - General.pdf   186 KB   1 version
Uploaded - 03-23-2026
pdf file
Patent Holder Statement - Specific.pdf   118 KB   2 versions
Uploaded - 07-18-2023

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