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OMB No. 2700-0095

Date: _________

NASA SBIR Company - Commercial Metrics
(Commercially Sensitive Information)

Nondisclosure: Unless you advise otherwise on this form, the information provided below will be considered by NASA as confidential commercial data and accordingly will not be disclosed for any purpose by NASA to non-NASA private or public parties, other than as part of data aggregated with that of other respondents, except for the compiling of this information by NASA subcontractor personnel for NASA program evaluation purposes.

1. Regarding your firm's commercial products or services, currently or formerly generating revenues in non-USG markets, which are based on or partially based on technology developed under NASA SBIR awards to your firm: (Note: "commercial" is defined to be non-U.S. Government (non-USG) markets. Count a "product line" of products having varying attributes as a single product. "Best estimate" data is sufficient if the requested data is not available or unreasonably burdensome to obtain.)
   
   

   			Cumulative Revenues ($ Millions) to Date Recognized by Your Firm from non-USG Sources
   Commercial Product or Service (include venture name, if different, and Reg. Trademark name, if any)	NASA SBIR Contract #'s Briefly Identify Commercial Application	Other (e.g. dividend) Associated with Each Comm'l Product/Service	Sales	License Fees/ Royalties	$ re: sell-off of technology)	Your Firm's No. of Full-Time Job Equivalents Currently Applied to RelatedCommercial Activities
   __________	__________	__________	__________	__________	__________	__________
   __________	__________	__________	__________	__________	__________	__________
   __________	__________	__________	__________	__________	__________	__________
   __________	__________	__________	__________	__________	__________	__________
   __________	__________	__________	__________	__________	__________	__________

   
   
2. Regarding your firm's efforts (successful or unsuccessful) & planning to date regarding commercial ventures to develop commercial products/services targeted to non-USG markets based on, or partially based on, technology developed under NASA SBIR Phase II awards(a) which were made to your firm, please provide the following information with respect to your firm:
   
   (A commercial venture is defined to be 1) a separate profit center established by your firm; or, 2) a profit center of another private entity that is a source of royalties, licensing fees, or dividends for your firm or that has been established based on the outright purchase of NASA SBIR related technology from you firm.)
   
   

   Venture Name

   Associated NASA SBIR Contract Numbers

   Cum. Priv. Cap Investment by Your Firm & by Partner Firms ($ M)

   No. of Spin Off Firms Formed (Names: Opt.*)

   No. of Joint Partnerships (JV's) Entered

   No. of Lic./ Roy. Agmts. Entered

   No. of Other Strategic Alliance Agreements Entered W/Priv. Entities

   No. of Other Firms Involved: (Names: Optional*)

   No. of Patents

   No. of Pat. Appl.

   Other Significant Business Development

   No Sig. BusinessDevelopment; but Some Preliminary Planning (e.g.mkt. research)

   JV's

   Lic./Roy.

   Other Agmts

   Yes

   No

   Yes

   No

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3. NASA SBIR Phase II awards (a) made to your firm for which NASA and/or non-NASA USG agencies provided Phase III funding to your firm:
   
   (Note: USG Phase III funding is defined to be sales to NASA or to non-NASA USG agencies plus post-Phase II development funding awarded by NASA or by non-NASA USG agencies.)
   
   

   	Cumulative USG Phase III Funding (in $ Millions) Received by Your Firm To Date		Your Firm's No. of Full-Time JobEquivalents (not accounted for in Section 1 above) currently applied to Related Phase III activities in USG Markets
   NASA SBIR Phase II (a) Contract No.'s	Phase III Funding From NASA	Phase III Funding From non-NASA USG Agencies
   __________	__________	__________	__________
   __________	__________	__________	__________
   __________	__________	__________	__________
   __________	__________	__________	__________

   
   
4. Comments:

(*) Optional names of any spin-off or partnering entities referred to above plus any other optional comments; use backside of this form, if necessary. Also, you may attach any marketing literature/other information on commercial applications of technology developed under NASA SBIR awards to your firm.

(a) If commercial ventures or USG Phase III funding resulted from NASA Phase I awards for which there were no follow-on NASA Phase II awards, then please provide the requested information with respect to those NASA Phase I awards.