Law Offices
KRATZ, QUINTOS & HANSON, LLP
Suite 400
1420 K Street N.W.
Washington, D.C. 20005
(202) 659-2930
Facsimile (202) 887-0357
Facsimile (202) 331-7519
TRADEMARK/SERVICE MARK INFORMATION SHEET
1. FROM (Attorney Name and Address):
2. APPLICANT (Name and Address) :
Name:
Address:
individual who is a citizen of the following
country:
a partnership organized under the laws of the following
country:
a corporation organized under the laws of the following
country:
other:
3. MARK:
(attach copy of the mark - words, lettering, designs etc.)
4. MARK USED WITH THE FOLLOWING GOODS AND/OR SERVICES:
5. Basis of the Application (Please complete one)
A. Application based on Use
First use anywhere
Country:
Date:
First use in commerce:
Date:
First use in interstate commerce with the United States:
Date:
Please attach specimens showing how the mark is actually being used. We must have specimens to file a use application.
B. Application based on intent to use
The mark currently has not been used anywhere and Applicant has a bona fide, or real, or actual intent to use the mark in commerce in the United States in the future.
Trademark/service Mark Information Sheet
Page 1
Rev. 07/07
6. APPLICATION OF THE MARK TO THE GOODS OR SERVICES:
A. The mark is used in connection with the goods by -
Applying the mark to the goods
Applying the mark to a label on the goods
Applying the mark to a container or package for the goods
Other:
Describe:
B. The mark is used in connection with the services by -
Using the mark in advertising or promotional material relating to the services
Other:
(Describe)
7. U.S. APPLICATION BASED ON CORRESPONDING FOREIGN APPLICATION OR CORRESPONDING FOREIGN REGISTRATION (Mark must be the same as the mark in the corresponding application or registration)
The application is based upon a foreign application filed within the past (6) months, namely:
Application No.:
Filed on:
Country:
The application is based upon a foreign registration (a certified copy must accompany the U.S. application, along with a verified English translation, if appropriate),
Registration No.
Registered Date:
Country:
Trademark/service Mark Information Sheet
Page 1
Rev. 07/07