Notice: Section 508 of the Workforce Investment Act of 1998 requires that all U.S. Federal Agencies make their websites fully accessible to individuals with disabilities. See 29 U.S.C. §794d. While the Trademark Electronic Application System (TEAS)
forms do comply with Section 508, the form previews currently do not meet all standards for web accessibility. If you cannot access a TEAS form preview or have any questions about this notice, please contact the Trademark Assistance Center (TAC) at 1-
800-786-9199 (select option#1), Monday-Friday, 8:30 a.m. to 8 p.m., ET.
PTO-1553
Approved for use through 03/31/2024. OMB 0651-0054
U.S. Patent and Trademark Office; U.S. DEPARTMENT OF COMMERCE
Under the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it contains a valid OMB control number
Allegation of Use
(Statement of Use/Amendment to Allege Use)
(15 U.S.C. §1051(c) or (d))
TEAS - Version 7.6
You may file an Allegation of Use ONLY before the application to register the mark has been approved for publication OR after a Notice of Allowance for the application has been issued. NOTE: To
delete a Section 1(b) filing basis entirely from an application, or as a basis for an entire class, you must use the specific Request To Delete Section 1(B) Basis, Intent To Use form. WARNING: Unlike
with an Amendment to Allege Use filed before an application has been approved for publication, you may not withdraw a Statement of Use (SOU) filed after a Notice of Allowance has been issued if
the SOU fails to meet the statutory requirements. However, you may file one "insurance" extension request with the SOU, or afterwards, in the limited situation where time remains in the existing six-
month period in which the SOU was filed. This would give you additional time to comply with the statutory requirements for filing the SOU.
NOTE: You must complete any field preceded by the symbol "*".
TIMEOUT WARNING: You're required to log back in after 30 minutes of inactivity. This ensures the USPTO complies with mandatory federal information security standards and protects user
information. After 25 minutes of inactivity, you will be prompted to continue your session. If you do not continue within 5 minutes, the session will end, you will be logged out of your USPTO.gov
account, and you will lose any unsaved data in the form. Please have all of your information ready before you start.
*Serial Number:
(required only if completing the Trademark/Service Mark Allegation of Use form; otherwise, access saved form, below)
OR
To upload a previously saved form file, first review the TEAS Help instructions for accessing previously saved data and then use the "Browse..." button below to access the form file saved
on your computer. WARNING: Failure to follow the TEAS Help instructions will result in the inability to edit your data.
If appropriate to file at this time, please answer all of the questions below to create an Allegation of Use form showing only sections relevant to you. Then press the NEXT button. For more information
regarding any of the following questions or topics, either go to HELP or click on the underlined word.
Is the applicant filing a Request to Divide as part of this Allegation of Use?
Yes No
If you have read and understood the above notice, you must check this box before you enter the proposed amended mark.
* Click the appropriate circle to indicate the
Mark type:
Standard Characters Special Form (Stylized and/or Design) Sound Mark
Use this section if you wish to modify a word(s), letter(s), punctuation, and/or number(s) with no design element and without claim to any particular font style, size or color.
Add/Modify the Standard Characters mark here: (Note: The entry can be in capital letters, lower case letters, or a combination thereof.)
NOTE
: After previewing the USPTO-generated image, if you object to the display of the
mark, then you must use "
Special Form (Stylized and/or Design)" option. Therein, you
could attach your own image file and check a box to claim standard characters. However, the
appropriateness of the standard character claim would later be determined as part of the
examination of the application. For how the USPTO determines w
hat the display of the
entered mark will be, click here.
Goods/Services/Collective Membership Organization Information
WARNING: If you recently added or deleted a class(es) of goods/services/a collective membership organization, and the correct class(es) are not displayed below, do not use this form. You must wait
until the changed data uploads into the USPTO databases, so that the display is correct before proceeding.
WARNING: Registration Subject to Cancellation for Fraudulent Statements
Statements made in filings to the USPTO must be are accurate; inaccuracies could result in the cancellation of a trademark registration. For example, an applicant's lack of use on all goods/services
for which use is claimed could jeopardize the validity of the registration and result in its cancellation.
Enter information for the Class
*International Class:
Current listing of goods/services/nature of the collective membership organization:
The mark is in use in commerce on or in connection with all of the goods/services, or to indicate membership in the collective organization listed in the application or Notice of Allowance or as subsequently
modified for this specific class.
This allegation of use does not cover this specific class. This entire class is permanently deleted from this application OR processed according to a Request to Divide
Deleted/Divided Goods/Services: This allegation of use does NOT cover the following goods/services listed in either the application or Notice of Allowance or as subsequently modified for this specific
class; these goods/services are being
permanently deleted or included in a Request to Divide:
LEAVE THIS SPACE BLANK IF THE FILING COVERS ALL THE GOODS/ALL THE SERVICES/THE COLLECTIVE MEMBERSHIP ORGANIZATION IN THE APPL
ICATION OR NOTICE OF
ALLOWANCE FOR THIS SPECIFIC CLASS. ONLY ENTER THE GOODS/SERVICES TO BE PERMANENTLY DE
LETED OR THAT ARE INCLUDED IN A REQUEST TO DIVIDE.
Remaining Goods/Services: The mark is in use in commerce on or in connection with the following goods/services listed in either the application or Notice of Allowance or as subsequently modified for this
specific class:
ENTER HOW THE
COMPLETE "FINAL" LISTING SHOULD READ THAT WILL IDENTIFY THE GOODS/SERVICES IN USE IN COMMERCE FOR THIS SPECIFIC APPLICATION (i.e., REMOVE
THOSE GOODS/SERVICES IDENTIFIED IN THE PRECEDING BOX). DO NOT ADD OR MODIFY ANY OTHER WORDING, AS SUCH CHANGES MAY NOT BE ACCEPTED BY THE USPTO.
Use Information
NOTE: If deleting an entire class, you can by-pass any fields listed therein as being "mandatory."
*Specimen File: A specimen is required showing the mark in use for each class in the application.
NOTE: For an instructional video on what is an appropriate specimen for a good or service, watch our Trademark Information Network video, entitled "Specimen" .
NOTE: For attachment, the JPG/PDF image file(s) showing the specimen(s) must be on your local drive. The Specimen File should show the overall context of how the mark is used, e.g., on the packaging for the
goods, in an advertisement for services, or on decals for use by members for collective membership marks, with the mark clearly displayed thereon or within. This image file should NOT show only the mark by
itself.
To attach your file, please note that:
*Click on the 'Click here to Attach Specimen(s)' button to select the file in JPG/PDF format (not exceeding 5 megabytes per attachment for JPG or 30 megabytes for PDF) or .WAV, .WMV, .WMA, .MP3, .MPG,
or .AVI format (not exceeding 5 megabytes for sound files or 30 megabytes for motion files).
0file(s) attached
Check this box if you are mailing a non-traditional specimen using USPS because it meets the qualifications explained in the hyperlink. Sound and motion specimens are not non-traditional and MUST be
submitted using this form. Failure to submit a required specimen through TEAS may result in processing delays and additional fees.
*Describe what the submitted specimen consists of
ADDITIONAL INFORMATION REQUIRED FOR WEBPAGE SPECIMENS:
Enter webpage URL(s) and date(s) of access below if it does NOT appear on the attached specimen.
Enter webpage URL(s) and dates(s) of access below if it does NOT appear on the attached specimen.
If your specimen consists of a webpage, provide the webpage URL:
If your specimen consists of a webpage, indicate the date you accessed or printed the webpage:
(MM/DD/YYYY)
*
Date of First Use of Mark Anywhere at least as early as:
(MM/DD/YYYY)
*
Date of First Use of Mark in Commerce at least as early as:
(MM/DD/YYYY)
Miscellaneous Information
To attach your file, please note that:
*Click on the 'Attach' button to select the file in JPG/PDF format (not exceeding 5 megabytes per attachment for JPG or 30 megabytes per attachment for PDF) or .WAV, .WMV, .WMA, .MP3, .MPG, or .AVI
format (not exceeding 5 megabytes for sound files or 30 megabytes for motion files).
0file(s) attached
Miscellaneous Statement: Enter information for which no other section of the form is appropriate.
Attorney Information
* Attorney Name
Firm Name
Individual Attorney
Docket/Reference Number
NOTE: You must limit your entry here to no more than 12 characters.
* Bar Membership
* Year of Admission
Select Year
* U.S. State/Commonwealth/Territory
* Membership Number
You must enter "N/A" or a membership/registration number if your U.S. state, commonwealth, or territory issues one. This number is not viewable in TSDR.
You must limit your entry here to no more than 40 alphanumeric characters.
* The attorney of record is an active member in good standing of the bar of the highest court of a U.S. state, the District of Columbia, or any U.S. Commonwealth or territory.
Other Appointed Attorney(s)
Recognized Canadian
Attorney/Agent
Internal Address
* Street Address
NOTE: You must limit your entry here, and for all remaining fields within this overall section (except City, see below), to no more than 40 characters (the storage limit for the
USPTO database). You may need to abbreviate some words, e.g., St. instead of Street. Failure to do so may result in an undeliverable address, due to truncation at the 40
character limit.
* City
NOTE: You must limit your entry here to no more than 22 characters.
* State
(Required for U.S. addresses)
NOTE: You must include as part of the "city" entry any information related to geographical regions (e.g., provinces) not found in the dropdown lists for "States" or "Countries."
Enter the city and then the geographical region, separated by a comma (e.g., Toronto, Ontario). In most instances, you will then also have to select the country within which the
region is found, below.
* Country/Region/Jurisdiction
/U.S. Territory
* Zip/Postal Code
(Required for U.S. and certain
international addresses)
Phone Number
Fax Number
* Email Address
The appointed attorney's email address must be provided and kept current with the USPTO.
NOTE: The owner/holder or the owner's/holder's attorney acknowledges that he or she is solely responsible for receiving USPTO emails. Additionally, the owner/holder or the
owner's/holder's attorney is responsible for periodically checking the status of the application/registration using the Trademark Status & Document Retrieval (TSDR) system.
USPTO notices and office actions issued in this application/registration can be viewed online using TSDR. The USPTO is not responsible for any failure to receive a USPTO-
issued email due to the receiver's security or anti-spam software, or any problems with the receiver's email system.
Correspondence Information
To make changes to the Primary Email Address for Correspondence below, either
(1) use the Owner Information section (if no attorney has been appointed) and enter the change, or
(2) use the Attorney Information section of the form to enter the change (if an attorney has been appointed).
Name
Email Address
Primary Email Address for Correspondence:
Secondary Email Address(es) (Courtesy Copies):
Enter up to 4 addresses, separated by either a semicolon or a comma.
Only the Primary Email Address for Correspondence is used for official communication by the USPTO. If an attorney has been appointed, the USPTO will correspond
ONLY with the appointed attorney; otherwise the USPTO will correspond with the applicant owner/holder. The applicant owner/holder or the appointed attorney must
keep this email address current with the USPTO.
NOTE: I understand that (1) a valid email address must be maintained by the applicant owner/holder and the applicant owner's/holder's attorney, if appointed, for
correspondence and (2) all official trademark correspondence must be submitted via the Trademark Electronic Application System (TEAS).
FEE INFORMATION
Amount
Allegation of Use Filing Fee per Class = $100
Note: The total fee is computed based on the Number of Classes in which the goods/services/collective membership organization associated with the mark is/are classified.
Number of Classes:
Amount for Allegation of Use (Number of Classes x $100): $100
TOTAL AMOUNT = $
NOTE: Three payment options (credit card, automated deposit account, and Electronic Funds Transfer) will appear after clicking on the PAY/SUBMIT button, which is available on the bottom of the
Validation Page after completing and validating this form.
Allegation of Use Signature Information
Click to choose ONE signature method:
Sign directly Email Text Form to second party for signature Handwritten pen-and-ink signature
Electronic Signature
To electronically sign this document, enter any alpha/numeric characters (letters/numbers) of your choosing, preceded and followed by the forward slash (/) symbol. Most signatories enter their name between the
two forward slashes; examples of acceptable "signatures" include: /john doe/; /jd/; or /123-4567/.
DECLARATION
Read the following statements before signing. Acknowledge the statements by checking the boxes and signing below.
The signatory believes that the applicant is the owner of the mark sought to be registered.
For a trademark or service mark application, the mark is in use in commerce on or in connection with all the goods/services in the application or notice of allowance, or as subsequently modified.
For a collective trademark, collective service mark, collective membership mark application, the applicant is exercising legitimate control over the use of the mark in commerce by members on or
in connection with all the goods/services/collective membership organization in the application or notice of allowance, or as subsequently modified.
For a certification mark application, the applicant is exercising legitimate control over the use of the mark in commerce by authorized users on or in connection with the all goods/services in the
application or notice of allowance, or as subsequently modified, and the applicant is not engaged in the production or marketing of the goods/services to which the mark is applied, except to advertise or
promote recognition of the certification program or of the goods/services that meet the certification standards of the applicant.
The specimen(s) shows the mark as used on or in connection with the goods/services/collective membership organization in commerce.
To the best of the signatory's knowledge and belief, no other persons, except, if applicable, authorized users, members, and/or concurrent users, have the right to use the mark in commerce, either in the
identical form or in such near resemblance as to be likely, when used on or in connection with the goods/services/collective membership organization of such other persons, to cause confusion or
mistake, or to deceive.
To the best of the signatory's knowledge, information, and belief, formed after an inquiry reasonable under the circumstances, the allegations and other factual contentions made above have evidentiary
support.
The signatory being warned that willful false statements and the like are punishable by fine or imprisonment, or both, under 18 U.S.C. § 1001, and that such willful false statements and the like may
jeopardize the validity of the application or submission or any registration resulting therefrom, declares that all statements made of his/her own knowledge are true and all statements made on
information and belief are believed to be true.
* Signature
Examples of acceptable "signatures" include: /john doe/; /jd/; or /123-4567/.
NOTE: Must be personally signed by the individual listed in the Signatory's Name field. 37 C.F.R.
§2.193(a). The person signing may not enter someone else's signature.
Only one signature is required, regardless of the number of applicants. To add a signature option, if
appropriate, use the "Add Signatory" button, below.
* Date Signed
(MM/DD/YYYY)
* Signatory's Name
* Signatory's Position
Enter appropriate title or nature of relationship to the owner/holder.
If the signer is
- An individual owner/holder, enter "Owner" or "Holder" as appropriate.
- Joint individual owners/holders, enter "Owners" or "Holders" as appropriate.
- A business entity authorized signatory, enter official title; e.g., "President" (if a corporation),"General Partner" (if a partnership), or "Principal" (if a limited liability company).
- A U.S.-licensed attorney, enter "Attorney of record," and if not specified in the application or prior communications, specify at least one state bar admission, e.g., "Attorney of
record, New York Bar member." Also, if the signing attorney is from the same U.S. firm as the attorney of record, but was not listed in the original filing and is not otherwise of
record, also include law firm name, e.g., Associate Attorney, Smith, Jones & Davis, Virginia Bar member.
Signatory's Phone Number
SUBMISSION SIGNATURE
Click to choose ONE signature method:
Sign electronically directly on this response form Email Text Form to second party for electronic signature Handwritten pen-and-ink signature
NOTE: Although a possible combination as selected on the form, the following signing method must NOT be used: declaration signed directly and submission signed through the email text form approach.
*You must click one of the three buttons below to confirm that you are legally authorized to sign this form based on the trademark rules governing representation of others before the USPTO.
If you have a U.S.
-licensed attorney representing you in this application, only your attorney can sign this response.
Owner/Holder who is not represented by an attorney (pro se): I hereby confirm that
I am not represented by an attorney in this matter, and am either: (1) the owner(s)/holder(s); or (2) a person or persons(s) with legal authority to bind the owner(s)/holder(s); and
If I had previously been represented by an attorney in this matter, either I revoked their power of attorney by filing a signed revocation with the USPTO or the USPTO has granted this attorney's withdrawal
request.
ADVISORY:
Click the above first button only if you are the owner(s)/holder(s) or legally authorized to bind the owner(s)/holder(s); such as an officer of the owner/holder corporation or association, or a general
partner of the owner/holder partnership.
Authorized U.S.-Licensed Attorney: I hereby confirm that
I am an attorney who is an active member in good standing of the bar of the highest court of a U.S. state (including the District of Columbia and any U.S. Commonwealth or territory);
I am currently the owner's/holder's attorney or an associate thereof;
To the best of my knowledge, if prior to my appointment another U.S.-licensed attorney not currently associated with my company/firm previously represented the owner/holder in this matter:
o the owner/holder has revoked their power of attorney by filing a signed revocation or substitute power of attorney with the USPTO;
o the USPTO has granted that attorney's withdrawal request;
o the owner/holder has filed a power of attorney appointing me in this matter; or
o the owner's/holder's appointed U.S.-licensed attorney has filed a power of attorney appointing me as an associate attorney in this matter.
Authorized Canadian Trademark Attorney/Agent: I hereby confirm that
An authorized U.S.-licensed attorney has been appointed to represent the owner;
I have been granted reciprocal recognition under 37 C.F.R. §11.14(c)(1) by the USPTO's Office of Enrollment and Discipline; and
I am an authorized signatory based on 37 C.F.R. §11.14(c)(2).
ADVISORY: Foreign attorneys (other than authorized Canadian attorneys/agents) may not sign responses and are prohibited from representing an owner/holder before the USPTO in trademark matters.
WARNING: If there are joint applicants and no appointed attorney is of record, ALL joint applicants must sign the submission signature. Since only one signature block is provided, enter all signature
information together in the same block, e.g., /jim smith/ /john jones/, and similarly provide the relevant information in the other blocks.
* Signature
Examples of acceptable "signatures" include: /john doe/; /jd/;
or /123-4567/.
NOTE: Must be personally signed by the individual listed in
the Signatory's Name field. 37 C.F.R. §2.193(a). The person
signing may not enter someone else's signature.
* Date Signed
(MM/DD/YYYY)
* Signatory's Name
* Signatory's Position
Enter appropriate title or nature of relationship to the owner/holder.
If the signer is
- An individual owner/holder, enter "Owner" or "Holder" as appropriate.
- Joint individual owners/holders, enter "Owners" or "Holders" as appropriate(all must sign the form).
- A business entity authorized signatory, enter official title; e.g., "President" (if a corporation),"General Partner" (if a partnership), or "Principal" (if a limited liability
company).
- A U.S.-licensed attorney, enter "Attorney of record," and if not specified in the application or prior communications, specify at least one state bar admission, e.g.,
"Attorney of record, New York Bar member." Also, if the signing attorney is from the same U.S. firm as the attorney of record, but was not listed in the original filing
and is not otherwise of record, also include law firm name, e.g., Associate Attorney, Smith, Jones & Davis, Virginia Bar member.
Signatory's Phone Number
Allegation of Use Signature Information
Click to choose ONE signature method:
Sign directly Email Text Form to second party for signature Handwritten pen-and-ink signature
Text Form for E-Signatures
NOTE: Only one signature is required, regardless of the number of owners/holders. If necessary, the actual signatory may complete the following fields directly on the Text Form, if you do not know who will be
signing the form.
Signatory's Name
Signatory's Position
Enter appropriate title or nature of relationship to the owner/holder.
If the signer is
- An individual owner/holder, enter "Owner" or "Holder" as appropriate.
- Joint individual owners/holders, enter "Owners" or "Holders" as appropriate.
- A business entity authorized signatory, enter official title; e.g., "President" (if a corporation),"General Partner" (if a partnership), or "Principal" (if a limited
liability company).
- A U.S.-licensed attorney, enter "Attorney of record," and if not specified in the application or prior communications, specify at least one state bar admission,
e.g., "Attorney of record, New York Bar member." Also, if the signing attorney is from the same U.S. firm as the attorney of record, but was not listed in the
original filing and is not otherwise of record, also include law firm name, e.g., Associate Attorney, Smith, Jones & Davis, Virginia Bar member.
Signatory's Phone Number
SUBMISSION SIGNATURE
Click to choose ONE signature method:
Sign electronically directly on this response form Email Text Form to second party for electronic signature Handwritten pen-and-ink signature
NOTE: Although a possible combination as selected on the form, the following signing method must NOT be used: declaration signed directly and submission signed through the email text form approach.
WARNING: If there are joint applicants and no appointed attorney is of record, ALL joint applicants must sign the submission signature. Since only one signature block is provided, enter all signature
information together in the same block, e.g., /jim smith/ /john jones/, and similarly provide the relevant information in the other blocks.
NOTE: Submission Signature is to be signed AFTER the declaration signing process is completed.
Allegation of Use Signature Information
Click to choose ONE signature method:
Sign directly Email Text Form to second party for signature Handwritten pen-and-ink signature
Text Form for Handwritten Signature Scanning
This option uses a Text Form (available after clicking on the Validate button) that will be signed by the proper signatory(ies) in the traditional "pen-and-ink" manner. Or, if you already have a signed declaration
for this application, you can attach it directly here, rather than relying on the USPTO's text form version. NOTE: If you are using the Text Form approach, you must after validation save the application data, and
then pull up the saved form to attach the scanned file for final submission.
Click on the Browse/Choose File button to select file that contains the scanned declaration/signature from your local drive. The scanned file should only include the declaration language with the appropriate
signature information (signature, signatory's name, signatory's position, and signature date). Do not include the entire application, but do ensure that the declaration language appears; i.e., a signature by itself
is not acceptable absent the required declaration language.
NOTE: Only one signature is required, regardless of the number of owners/holders. If necessary, the actual signatory may complete the following fields directly on the Text Form, if you do not know who will be
signing the form. If left blank, you will initially receive a WARNING message, which you can by-pass by clicking the "Continue" button. After receipt of the signed declaration, you must then use the information
provided therein to complete the fields for "Signatory's Name" and "Signatory's Position." At the time of final submission, these are mandatory fields, which will produce an ERROR if left blank.
* Signatory's Name
* Signatory's Position
Enter appropriate title or nature of relationship to the owner/holder.
If the signer is
- An individual owner/holder, enter "Owner" or "Holder" as appropriate.
- Joint individual owners/holders, enter "Owners" or "Holders" as appropriate.
- A business entity authorized signatory, enter official title; e.g., "President" (if a corporation),"General Partner" (if a partnership), or "Principal" (if a limited
liability company).
- A U.S.-licensed attorney, enter "Attorney of record," and if not specified in the application or prior communications, specify at least one state bar admission,
e.g., "Attorney of record, New York Bar member." Also, if the signing attorney is from the same U.S. firm as the attorney of record, but was not listed in the
original filing and is not otherwise of record, also include law firm name, e.g., Associate Attorney, Smith, Jones & Davis, Virginia Bar member.
Signatory's Phone Number
SUBMISSION SIGNATURE
Click to choose ONE signature method:
Handwritten pen-and-ink signature
NOTE: Although a possible combination as selected on the form, the following signing method must NOT be used: declaration signed directly and submission signed through the email text form approach.
*You must click one of the three buttons below to confirm that you are legally authorized to sign this form based on the trademark rules governing representation of others before the USPTO.
If you have a U.S.
-licensed attorney representing you in this application, only your attorney can sign this response.
Owner/Holder who is not represented by an attorney (pro se): I hereby confirm that
I am not represented by an attorney in this matter, and am either: (1) the owner(s)/holder(s); or (2) a person or persons(s) with legal authority to bind the owner(s)/holder(s); and
If I had previously been represented by an attorney in this matter, either I revoked their power of attorney by filing a signed revocation with the USPTO or the USPTO has granted this attorney's withdrawal
request.
ADVISORY:
Click the above first button only if you are the owner(s)/holder(s) or legally authorized to bind the owner(s)/holder(s); such as an officer of the owner/holder corporation or association, or a general
partner of the owner/holder partnership.
Authorized U.S.-Licensed Attorney: I hereby confirm that
I am an attorney who is an active member in good standing of the bar of the highest court of a U.S. state (including the District of Columbia and any U.S. Commonwealth or territory);
I am currently the owner's/holder's attorney or an associate thereof;
To the best of my knowledge, if prior to my appointment another U.S.-licensed attorney not currently associated with my company/firm previously represented the owner/holder in this matter:
o the owner/holder has revoked their power of attorney by filing a signed revocation or substitute power of attorney with the USPTO;
o the USPTO has granted that attorney's withdrawal request;
o the owner/holder has filed a power of attorney appointing me in this matter; or
o the owner's/holder's appointed U.S.-licensed attorney has filed a power of attorney appointing me as an associate attorney in this matter.
Authorized Canadian Trademark Attorney/Agent: I hereby confirm that
An authorized U.S.-licensed attorney has been appointed to represent the owner;
I have been granted reciprocal recognition under 37 C.F.R. §11.14(c)(1) by the USPTO's Office of Enrollment and Discipline; and
I am an authorized signatory based on 37 C.F.R. §11.14(c)(2).
ADVISORY: Foreign attorneys (other than authorized Canadian attorneys/agents) may not sign responses and are prohibited from representing an owner/holder before the USPTO in trademark matters.
WARNING: If there are joint applicants and no appointed attorney is of record, ALL joint applicants must sign the submission signature. Since only one signature block is provided, enter all signature
information together in the same block, e.g., /jim smith/ /john jones/, and similarly provide the relevant information in the other blocks.
* Signature
Examples of acceptable "signatures" include: /john doe/; /jd/;
or /123-4567/.
NOTE: Must be personally signed by the individual listed in
the Signatory's Name field. 37 C.F.R. §2.193(a). The person
signing may not enter someone else's signature.
* Date Signed
(MM/DD/YYYY)
* Signatory's Name
* Signatory's Position
Enter appropriate title or nature of relationship to the owner/holder.
If the signer is
- An individual owner/holder, enter "Owner" or "Holder" as appropriate.
- Joint individual owners/holders, enter "Owners" or "Holders" as appropriate(all must sign the form).
- A business entity authorized signatory, enter official title; e.g., "President" (if a corporation),"General Partner" (if a partnership), or "Principal" (if a limited liability
company).
- A U.S.-licensed attorney, enter "Attorney of record," and if not specified in the application or prior communications, specify at least one state bar admission, e.g.,
"Attorney of record, New York Bar member." Also, if the signing attorney is from the same U.S. firm as the attorney of record, but was not listed in the original filing
and is not otherwise of record, also include law firm name, e.g., Associate Attorney, Smith, Jones & Davis, Virginia Bar member.
Signatory's Phone Number