Technology Licensing TAHA Proprietary Technology Thank you for your interest in licensing technology from www.tahacorp.com. Please complete the form below. All fields marked with an asterisk (*) are mandatory. Name* Organization Name* Position/Title* Email Address* Phone Number* Address* Street City State/Province Postal Code Country Technology Interest 1. Which technology are you interested in licensing? 2. Intended use of the technology 3. Briefly describe how your organisation plans to use the technology Business and Legal Details 1. Do you have prior experience with similar technology? (Yes/No): SelectYesNo * If yes, please provide details: 2. Estimated timeframe for implementing the technology:* 3. Are there any specific licensing terms or requirements you wish to propose? (Yes/No): SelectYesNo * If yes, please provide details: Acknowledge By submitting this form, I acknowledge that the information provided is accurate and that submitting this form does not constitute a licensing agreement. Further discussions and evaluations will follow upon review of the application.