Trademark name: *

Applicant's name: *

Applicant's Email: *

Applicant's address: *

Applicant's country of citizenship: *

Definition of goods or services associated with Mark to be registered. Please be as detailed and specific as possible. Even if you believe that two products you offer fall within the same “classification of goods or services,” please specify them so I can be sure.

Define International class (if you know):

• a.
  Certified copies of Certificate of Registration or application:
• b.
  Certified copies of Certificate of Registration or application:
• c.
  Certified copies of Certificate of Registration or application:

Is mark presently used in commerce anywhere for those goods and services?

YesNoUnsure

Date of first use by applicant and country where first used. Please be as specific as possible. If you only recall the month, the USPTO will assume it’s the last day of that month. If you only recall the year, the USPTO will assume it’s the last day of that year. Thus, it is important to be as specific as possible:

Date of first use by applicant in commerce, i.e. between two U.S. states or between foreign country and US state:

Define/explain how mark is used in commerce:

If there is no present use in commerce of the mark, when do you anticipate first using the mark in commerce for the goods/services to be registered?

If the mark is presently used in commerce, please provide:

If corporate applicant, who will be the authorized corporate representative to execute all necessary declarations, power of attorney, designation of domestic representative:

Are you aware of any conflicting or similar trademarks used by anyone else? If so, please explain in detail:

Please list below the name, position, address, telephone number, fax number and e-mail address for contact person most knowledgeable about this application.