Derivative Impact Report Form - AI2 ImpACT License

Generate and complete a Derivative Impact Report for the AI2 ImpACT License here.

Instructions:

Capitalized terms used in this form have the meanings provided in the AI2 ImpACT License.

If you developed both a Model Derivative and a Data Derivative, please submit separate a Derivative Impact Report for each Derivative.

Please respond to all questions. If a question does not apply to you or your Derivative, please respond "N/A" when prompted.

Email:

Please provide your email address. If you are completing this form on behalf of an entity or institution, please use your entity/institutional domain.

Name: Individual or Organization

Please provide your full legal name OR the full legal name of your entity/institution for which you are completing this Derivative Impact Report. No nicknames, abbreviations, or aliases, please.

Intended Use: What is the intended use of the Derivative?

Intended Users: Who are the intended users of the Derivative?

Funding: What is the source of funding for the program, project, or initiative that developed the Derivative?

Check all that apply.

Private Sector

Public Sector/Government Sector

Philanthropic/Nonprofit Sector

Confidential/Elect Not to Disclose

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