8 & 9 Trademark Renewal Form

Any change to Registrant's Address? *

If there has been an address change since date of registration please provide in miscellaneous section below

No

Yes

Confirm Continued Use of the Mark in Interstate Commerce in the United States *

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 since the date of registration and is still in use in commerce on or in connection with all goods services 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 since the date of registration 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.

Credit Card Type *

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 *

Please enter credit card expiration date - **PLEASE ENTER "01" in the Day field

MM

DD

YYYY

Credit Card Authorization *

By checking this box you authorize Robert S. Broder, PLLC to charge your credit card the amount above.

Declaration Section 8 & 9 *

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) showing the mark as used in commerce.

The specimen(s) shows the mark as currently used in commerce on or in connection with the goods/services/collective membership organization.

The registrant requests that the registration be renewed for the goods/services/collective organization identified above.

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, 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 *

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.