1. Information About Developer

1. a) Name:
   Entity Name: (Check Appropriate) Public Entity/ Private Entity/ Institution/ Researcher/ Developer/ Individua)
   Qualification:
   Affiliation Name: (Full-Time, Part-Time, Self-Employed, Self-Researcher)
   Nationality:
2. c) Contact details of technical resources available to support technology manufacturing:

2. Technology Development

1. a) Technology/Product/Process Name:
2. b) Synopsis: Submit Annexures (Photographs, Videos, Brochures, If Any)
3. c) Is the prototype available?

   Yes

   No
4. d) Purpose of this Technology:
5. e) Which industry sector the technology targets?
6. f) Year in which you developed this technology

1. g) Any patent filed, regulatory, or other approvals required (list):
2. h) Any patent filed, regulatory, or other approvals required (list):
3. i) Potential beneficiaries of this technology:
4. j) Who would be the end user of the technology/product/process?
5. k) How would the end user benefit from the technology?
6. l) How would the end user benefit from the technology?

   Yes

   No

3. Technology Production Capacity

1. a) Research Centre/ Lab/ Facility used to develop the Technology:
2. b) Is the facility currently available to develop the product / technology on Pilot scale:
3. c) Are raw material available to develop the product / technology on Pilot scale:
4. d) If pilot production facility is unavailable, identify what resources and investment would be required to enable pilot production:
5. e) Present production capacity (daily/ monthly/ annually):

4. Cost of Production

1. a) What is the cost of producing one unit within own facility:
2. b) What is the cost of producing one unit, if at mass scale production (State figures):

5. Sales and Marketing

1. a) Has Technology/Product/Process been sold yet?

   Yes

   No
2. b) Sale Price of Technology:
3. c) What are the competing local / imported products?
4. d) What is the Unique Selling Point (USP) of the Technology?

6. Sustainability

1. a) How “Green” (environmental friendly and ecologically responsible) is your technology, and what is its ‘carbon footprint’*?
   *Carbon footprint definition: The total amount of greenhouse gases (including carbon dioxide and methane) that are generated by our actions.
2. b) Are you using sustainable products and processes for the development of your technology?
3. c) What are the competing local / imported products?
4. d) What is the Unique Selling Point (USP) of the Technology?

7. Perceived Estimated Impact

1. a) What is the perceived impact of this technology on:

   Local Economy
   National Economy
   Service Delivery
   Employment Generation
   Environment
   Society / Culture

2. Attach Annexures (If Any)

   b) Any environmental impact assessment conducted/required?

8. Perceived Estimated Impact

9. What Support Do You Expect From Stedec?