NOAA SBIR: Disclosures of Foreign Affiliations or Relationships to Foreign Countries

------------------------------------------------------ Responses to disclosure questions may contain trade secrets or commercial or financial information that is privileged or confidential and is exempt from public disclosure. Such information shall be used or disclosed only for evaluation purposes or in accordance with an award between the submitter and the Government.

Definitions

Covered Individual — means an individual who: (A) contributes in a substantive, meaningful way to the scientific development or execution of a research and development project proposed to be carried out with a research and development award from a federal research agency. (B) is designated as a covered individual by the Federal research agency concerned. Note: NOAA considers all key personnel included in the SBIR application to be covered individuals. Foreign Affiliation — a funded or unfunded academic, professional, or institutional appointment or position with a foreign government or government-owned entity, whether full-time, part-time, or voluntary. This includes appointments or positions deemed adjunct, visiting, or honorary with research institutions located in a foreign country of concern. Foreign Country of Concern — includes the People's Republic of China, the Democratic People's Republic of Korea, the Russian Federation, the Islamic Republic of Iran, or any other country determined to be a country of concern by the U.S. Secretary of State. https://www.sbir.gov/foreign_disclosures Malign Foreign Talent Recruitment Program — as defined in section 19237 of title 42 of U.S. Federal Code. Federally Funded Award — means a Phase I, Phase II, or Phase III SBIR or STTR award made using a funding agreement.

Instructions

Please complete the applicable form fields below. If you require additional space, you may attach a separate document with your answers. If you have any questions or would like clarification, please contact us at sbir.noaa@noaa.gov. Complete definitions of terms used below are available in 42 U.S. Code § 19237 - Definitions.

Company Name*

EIN (Tax ID) or UEI Number from SAM.gov*

Name of Person Submitting Form*

Email address of Person Submitting Form*

Project Title*

1. Is any owner or covered individual of the applicant or awardee party to any malign foreign talent recruitment program?*

Yes

If yes, disclose the first and last name of each owner or covered individual, identify their role (i.e., owner or covered individual), and the malign foreign talent recruitment program.

If you need additional space, you may attach a separate file below.

2. Is there a parent company, joint venture, or subsidiary, of the applicant or awardee that is based in, or funded by, any foreign country of concern?*

Yes

If yes, disclose the name, full address, applicant or awardee relationships (i.e., parent company, joint venture, or subsidiary) of each entity based in, or funded by, any foreign country of concern.

If you need additional space, you may attach a separate file below.

3. Does the applicant or awardee have any current or pending contractual or financial obligation or other agreement specific to a business arrangement, or joint venture-like arrangement with an enterprise owned by a foreign state or any foreign entity?*

Yes

If yes, disclose the name of each enterprise or foreign entity, type of obligation, agreement, or arrangement (i.e., contractual, financial, or other), description of obligation, agreement, or arrangement, and the foreign state or foreign entity country.

If you need additional space, you may attach a separate file below.

4. Is the applicant or awardee wholly owned in a foreign country?*

Yes

If yes, disclose the name of the foreign country

5. Does the applicant or awardee have any venture capital or institutional investment?*

If yes, proceed to question 5a. If no, proceed to question 6.

Yes

5a. Does the investing entity have a general partner or individual holding a leadership role who has a foreign affiliation with any foreign country of concern?

Yes

If yes or unable to determine, disclose the venture capital or institutional investment entity name, and the percentage of ownership obtained by the entity, and the type of investment (i.e., equity, debt, or combination of equity and debt).

If you need additional space, you may attach a separate file below.

6. During the previous 5-year period, did the applicant or awardee have any technology licensing or intellectual property sales or transfers, to a foreign country of concern?*

Yes

If yes, disclose the name, address, and country, of the institution or entity that licensed, purchased, or received the intellectual property.

If you need additional space, you may attach a separate file below.

7. Is there any foreign business entity, offshore entity, or entity outside the United States related to the applicant or awardee?*

Yes

If yes, disclose the entity name, relationship type (i.e., foreign business entity, offshore entity, entity outside the United States), description of relationship, and entity address and country.

If you need additional space, you may attach a separate file below.

8. Does the applicant or awardee have an owner, officer, or covered individual that has a foreign affiliation with a research institution located in a foreign country of concern?*

Yes

If yes, disclose the first and last name of each owner, officer, or covered individual, identify their role (i.e., owner, officer, or covered individual), and the name of the foreign research institution and the foreign country of concern where it is located

If you need additional space, you may attach a separate file below.

File Attachments

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