LETTER OF ASSURANCE FOR ESSENTIAL PATENTS
Please mail, pdf or FAX to:	Secretary, IEEE-SA Standards Board Patent Committee 
			Institute of Electrical and Electronics Engineers, Inc.
			445 Hoes Lane 
			Piscataway, NJ 08854 USA
			Email: _____________________ 
			FAX (+1 732-875-0524) 

Except as expressly provided below, no license or covenant is implied by submission of this Letter of Assurance

Note: No ad hoc assurances will be accepted; only Letters of Assurance authorized by the IEEE Standards Board may be used.  This assurance applies from the date of the earlier of (i) submission of this letter of assurance, or (b) the standard’s approval, to the date of the standard’s withdrawal and is irrevocable during that period  This assurance also irrevocably applies to compliant implementations of all previous and subsequent standards that make use of the technology substantially the same as that in the [Proposed} IEEE Standard identified below until each previous or subsequent standard is withdrawn.  A subsequent assurance may only supersede a former assurance if the subsequent assurance is less restrictive than the former assurance; otherwise the former assurance continues to apply.  A patent holder/organization may submit multiple assurances.  Every attendee of a Working Group meeting must submit an assurance for any patent holder/organization that sponsors the attendee’s participation in the Working Group.

A. PATENT HOLDER/ORGANIZATION: 
Legal Name of Organization: ________________________________________________________________ 
B. PATENT HOLDER’S CONTACT FOR LICENSE APPLICATION: 
Name & Department: _______________________________________________________________________ 
Address: _________________________________________________________________________________ 
Telephone: ______________________ Fax: _________________ E-mail: _____________________________ 
URL: ____________________________________________________________________________________ 
Note: The IEEE takes no position with respect to the reasonableness of rates, terms, and conditions of the license agreements offered by patent holders or patent applicants. 
C. IEEE STANDARD or PROPOSED IEEE STANDARD: 
Number: _________________________________
Title: ____________________________________________________________________________________
D. PATENT HOLDER'S POSITION REGARDING LICENSING ESSENTIAL PATENT RIGHTS: 
In accordance with Clause 6 of the IEEE-SA Standards Board Bylaws, the Patent Holder hereby declares and covenants for itself, its subsidiaries and affiliates, and the successors and assigns of their patent rights that its licensing position with respect to any patent(s) and/or patent application(s) that it may hold or control, the use of which would be essential to create a compliant implementation of the [Proposed] IEEE Standard identified above, is as follows (check one primary box only of 1 – 5 below):

1	□  RF Licensing Commitment.  The Patent Holder will grant a license without compensation to an unrestricted number of applicants on a worldwide, non-discriminatory basis with reasonable terms and conditions to comply with the [Proposed] IEEE Standard.
		□  (Optional) A sample license is attached

2	□  RAND Licensing Commitment.  The Patent Holder will grant a license under reasonable rates to an unrestricted number of applicants on a worldwide, non-discriminatory basis with reasonable terms and conditions to comply with the [Proposed] IEEE Standard.  Reasonable rates will not exceed __________________________________________ (must fill in).  Reasonable rates mean what a willing licensor and a willing licensee would agree to in an arms length transaction in a competitive environment before adoption of the [Proposed] IEEE Standard and before significant investment by the licensee

		□  (Optional) A sample license is attached

3	□  Non-enforcement Commitment.  The Patent Holder states that, without conditions, it will not enforce any of its present or future patent(s) against any person or entity with respect to a compliant implementation of the [Proposed] IEEE Standard

4	□  The Patent Holder is unwilling to grant licenses according to the provisions of 1, 2 or 3 above.  

5	□  After reasonable inquiry, Organization is not aware of any patent(s) and/or patent application(s), and has no present plans to  file and will not amend any patent applications or file any new patent applications that Organization may hold or control that would be essential to create a compliant implementation of the [Proposed] IEEE Standard. 

[Note: Completion of the following section is optional. Nothing in this Letter of Assurance shall be interpreted as giving rise to a duty to conduct a patent search other than for provision 5 above] 
If the Patent Holder owns or controls patent(s) and/or application(s) that it believes may be essential to create a compliant implementation of the [Proposed] IEEE Standard, please specify the following: 
	Patent/Application Number: __________________________________________________________
		Title: ____________________________________________________________________ 
	Patent/Application Number: __________________________________________________________
		Title: ____________________________________________________________________

	Patent/Application Number: __________________________________________________________
		Title: ____________________________________________________________________
Use additional pages, as necessary. 
E. SIGNATURE: 

Print name of authorized person: ______________________________________________________________ 
Title of authorized person: ___________________________________________________________________ 
Signature of authorized person: ______________________________________ Date: ____________________ 
Copyright © 2005 IEEE; Approved by IEEE-SA Standards Board Patent Committee – ________________ 2005