Legal Intellectual Property Infringement Questionnaire

Instructions for Use: This questionnaire is designed to assist us in identifying and evaluating potential intellectual property (IP) infringement issues concerning our assets. It should be completed by any employee, contractor, or partner who suspects that our intellectual property may have been infringed upon by a third party. Your responses will enable our legal and IP management teams to assess the situation accurately and determine the appropriate course of action. Please provide as much detailed information as possible and attach any relevant documentation or evidence that supports your observations.

Information about the Respondent

Name		Position/Title
Department		Contact Info

Description of Suspected Infringement

Type of Intellectual Property Involved	Patent Trademark Copyright
Location/Platform where the Infringement was Observed
Detailed Description of Suspected Infringement

Information about the Alleged Infringer

Name of Individual/ Organization
Relationship to Our Organization (if any)
Known Contact Information

Evidence of Infringement

Description of Evidence Collected	Photographs Screenshots Product Samples
Location of Evidence (if digital, please specify file storage details)
Any Communication with the Alleged Infringer (please attach copies of correspondence, if any)

Impact on Our Organization

Estimated Impact on Operations
Feedback/Complaints Received from Customers/Partners (if any)

Declaration

By submitting this questionnaire, I declare that the information provided is accurate and complete to the best of my knowledge. I understand that this information will be used to assess and possibly initiate legal action regarding the suspected intellectual property infringement.

[Signature]

[Date]

Upon completion, please submit this questionnaire to our legal department through the designated submission channel. Our team will review the submission and may contact you for further information or clarification.