Registrant's Name
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Any change to Registrant's Address?
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If there has been an address change since date of registration please provide in miscellaneous section below
No
Yes
Email Address
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Registration Number, if known
Confirm Continued Use of the Mark in Interstate Commerce in the United States
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The mark is in use in commerce on or in connection with all of the goods/all of the services/to indicate membership in the collective membership organization listed in the existing registration for this specific class; and the mark has been continuously used in commerce for five (5) consecutive years after the date of registration, or the date of publication under Section 12(c), and is still in use in commerce on or in connection with all goods/all services/the collective membership organization listed in the existing registration for this class. WARNING: Any class or item designated below will be permanently deleted from the registration and may NOT be later reinserted.
Deleted Goods/Services: The mark is in use in commerce on or in connection with all of the goods/services listed in the existing registration for this specific class; and the mark has been continuously used in commerce for five (5) consecutive years after the date of registration, or the date of publication under Section 12(c), and is still in use in commerce on or in connection with all goods or services listed in the existing registration for this class. The above statements are all true, EXCEPT for the goods/services listed below. In the following space, list only those goods/services appearing in the registration that this filing does NOT cover and that should be permanently deleted (removed from the registration). WARNING: Any item listed below will be permanently deleted from the registration and at that point may NOT be reinserted.
Deleted goods/services, if any
Miscelleanous Statement/Address Change
Credit Card Type
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Please select credit card type
Visa
American Express
Mastercard
Discover
Cardholder Name
First Name
Last Name
Credit Card Billing Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Expiration Date
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Please enter credit card expiration date - **PLEASE ENTER "01" in the Day field
MM
DD
YYYY
Credit Card Authorization
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By checking this box you authorize Robert S. Broder, PLLC to charge your credit card the amount above.The total charge may appear as two seperate charges - one to USPTO for filing fees and the other to Robert S. Broder, PLLC for filing service fee.
Declaration
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Read the following statements before signing. Acknowledge the statements by checking the boxes and signing below.
Unless the owner has specifically claimed excusable nonuse, the mark is in use in commerce on or in connection with the goods/services or to indicate membership in the collective membership organization identified above, as evidenced by the attached specimen(s).
Unless the owner has specifically claimed excusable nonuse, the specimen(s) shows the mark as currently used in commerce on or in connection with the goods/services/collective membership organization.
The mark has been in continuous use in commerce for five consecutive years after the date of registration, or the date of publication under 15 U.S.C. § 1062(c), and is still in use in commerce on or in connection with all goods/services, or to indicate membership in the collective membership organization, listed in the existing registration.
There has been no final decision adverse to the owner's claim of ownership of such mark for such goods/services, or to indicate membership in the collective membership organization, or to the owner's right to register the same or to keep the same on the register.
There is no proceeding involving said rights pending and not finally disposed of either in the United States Patent and Trademark Office or in a court.
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 this submission and the registration, 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.
Power of Attorney
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By checking this box Registrant hereby appoints or reappoints Robert S. Broder, PLLC, 1129 Northern Blvd, Suite 404, Manhasset, NY 11030 to transact all business in the Patent and Trademark Office in connection with the above-referenced registration.