Seller Information Form

Please provide as much information as possible. An RPX representative will contact you within two business days.

*Seller/Company Name:

Please enter your Company Name

*First Name:

Please enter your First Name

*Last Name:

Please enter your Last Name

Address:

City:

State/Province:

Zip:

Country:

*Phone:

Please enter your Phone No

*E-Mail:

Please enter a valid Email Id

Broker Name, if Applicable:

Owner of Patents:

Patent/Application Numbers:

*Bid Deadline, if Applicable:

Please enter a Bid Deadline

*Valuation Expectations:

Please enter your valuation expectations

Please provide a brief description of the technology and to whom it applies:

*You agree to the terms and conditions of our Non-Notice Agreement:

Please check on terms and conditions

By pressing the “Submit” button below, you agree to the terms and conditions of our Non-Notice Agreement.