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Notice
regarding Section 508 of the Workforce Investment Act of 1998:
Section 508 of the Workforce Investment Act of 1998 requires that all
U.S. Federal Agencies make their web sites 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 PDF preview of the TEAS forms 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-1583 
Approved
						for use through xx/xx/20xx. OMB 0651-0055 
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 
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							Combined
							Declaration of Use and Incontestability Under Sections 8 and
							15
						 | 
					 
					
						
							(15
							U.S.C. §§ 1058 & 1065) 
 
TEAS - Version
							7.6 
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									You
									may file a Combined Declaration of Use &
									Incontestability under Sections 8 & 15 only if you have
									continuously used a mark registered on the Principal
									(not Supplemental)
									Register in commerce for five (5) consecutive years after
									the date of registration. You must file the Combined
									Declaration, specimen, and fee on a date that falls on or
									between the fifth (5th) and sixth (6th) anniversaries of the
									registration (or, for an extra fee of $100.00 per class, you
									may file within the six-month grace period following the
									sixth anniversary date). If you have NOT continuously used
									the mark in commerce for five (5) consecutive years, you
									must still file
									a Section 8 Declaration. You must subsequently file a
									Section 8 declaration, specimen, and fee on a date that
									falls on or between the ninth (9th) and tenth (10th)
									anniversaries of the registration, and each successive
									ten-year period thereafter (or, for an extra fee of $100.00
									per class, you may file within the six-month grace period).
									FAILURE TO FILE THE SECTION 8 DECLARATION WILL RESULT IN
									CANCELLATION OF THE REGISTRATION. Note:
									Because the time for filing a ten-year Section 8 declaration
									coincides with the time for filing a Section 9 renewal
									application, a combined
									Sections 8 & 9 form exists. 
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									NOTE: You
									must complete any field preceded by the symbol "*". 
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									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. 
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						* Enter
						a Registration Number:
						  
					 | 
					
						   
  (required
						only if completing the form for the first time) 
WARNING:
						Be sure you are entering a registration number and NOT a serial
						number. 
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			     OR 
			
			 
			 
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Instructions: 
									
									To
									file this form, please complete the following steps: 
 
									 
									
										Fill
										out all fields for which information is known. Fields with
										a * symbol
										are mandatory for filing purposes and must be completed. 
										Validate
										the form, using the "Validate" button at the end
										of the form. If there are errors, go back to step 1. 
										Use
										the Pay/Submit button at the bottom of the Validation
										Screen. This will allow you to choose from 3
										different payment
										methods: credit card,
										automated deposit account, or electronic funds transfer.
										After accessing the proper screen for payment, and making
										the appropriate entries, you will receive a confirmation
										screen if your transmission is successful. Or, use the
										"Save Form" button to save your work for
										submission at a later time. 
										An
										email acknowledging receipt of the submission (a filing
										receipt) will be sent to the Primary Email Address for
										Correspondence. 
									 
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									Registration
									Number 
								 | 
								
									 
									 
								 | 
							 
							
								
									Mark 
								 | 
								
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
								 | 
							 
							
								
									Owner/Holder
									Information 
								 | 
								
									 
									 
									 
									 
									 
									 
									 
Email
									Address:  
								 | 
							 
							
								
									Attorney 
Information 
								 | 
								
									 
									 
									 
									 
									 
									 
									 
Email
									Address:  
								 | 
							 
							
								
									Primary
									Email Address 
for Correspondence 
Warning: This
									is the email address currently of record in the USPTO
									database. If it is not the email address of either the
									appointed attorney, if any, otherwise the owner, it must be
									updated. 
								 | 
								
									 
									 
								 | 
							 
							
								
									Secondary
									Email Address(es) 
(Courtesy Copies) 
								 | 
								
									 
									 
								 | 
							 
							
								
									Registration
									Date 
								 | 
								
									 
									 
								 | 
							 
						 
						 
						 
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			Updates
			to the owner's/holder's and appointed attorney's address(es) can
			be made within this form. If no attorney is appointed, the
			owner's/holder's email address is the Primary Email Address for
			Correspondence. 
			
				
				
					
						
							
							
								
									The
									Attorney Information page will automatically
									display within this
									form for editing or removing the attorney information
									appearing above. 
Power
									of Attorney: The USPTO
									considers the power of attorney to end: (1) upon the date of
									registration; or (2) the final acceptance or denial of a
									required post-registration filing. Filing this form will
									automatically update the Attorney of Record and the Primary
									Email Address for Correspondence in the USPTO's Trademark
									Status & Document Retrieval (TSDR) database.
									It is not necessary to file a separate appointment
									form. 
Foreign-domiciled
									owners/holders must
									have a U.S.-licensed attorney represent
									them before the USPTO in any application-or
									registration-related filing. Information
									about hiring a U.S.-licensed attorney can
									be found on the USPTO website. 
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						Owner
						Information 
						Instructions: 
Update
						the mailing address, if
						needed. The address entered on this page is publicly viewable
						in the USPTO's TSDR database
						and is presumed to be the owner's/holder's domicile. 
					 | 
				 
				
					
						* Owner 
					 | 
					
						 
 
 
 Check
						this box only if the owner listed above does not identify the
						current trademark owner. The trademark owner is the legally
						recognized entity or individual that owns the trademark. 
 
If
						there has been a change in ownership or legal name of the
						owner, you must enter the new owner in this form. Instructions
						will be provided when you check the box. For more information,
						see our webpage
						on modifying owner information in online forms. 
					 | 
				 
				
					
						 
 DBA (doing
						business as)  
 AKA
						(also known as) 
 
 TA
						(trading as)  
 Formerly 
					 | 
					
						 
 
					 | 
				 
				
					
						Legal
						Entity Type: Corporation 
						Citizenship/State, Country,
						Region, or Jurisdiction Where Organized: Indiana 
 
 
 Check
						this box only if no information is listed in the field/s or if
						the information listed is not correct for the current owner of
						the trademark. 
 
Instructions will be provided when
						you check the box. 
					 | 
				 
				
					
						Internal
						Address 
					 | 
					
						 
 
					 | 
				 
				
					
						* Mailing
						Address 
(Entered
						address is publicly viewable in the USPTO's 
TSDR database.
						This address must be capable of receiving mail and may be your
						street address, a P.O. box, or a "care of" address.) 
					 | 
					
						 
 
 
NOTE: You
						must limit your entry here, and for all remaining fields within
						this overall section, 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. owners only) 
					 | 
					
						 
 
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) 
					 | 
					
						 
 
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						Domicile
						Address 
(Entered
						address is not publicly viewable in the USPTO's TSDR database
						unless it is the same as the mailing address. If your mailing
						address is not your domicile, you must enter the number,
						street, city, state, country or U.S. territory, and if
						applicable, zip/postal code of your domicile address.
						In most cases, a P.O. box, "care of" address, or
						similar variation is not acceptable as a domicile address.) 
					 | 
					
						 
 Uncheck
						this box if the Domicile Address and mailing address of the
						applicant owner/holder are NOT the same. 
 
 
Indicate
						place you reside and intend to be your principal home (for
						individual) or your principal place of business (for entity). 
					 | 
				 
				
					
						Phone
						Number 
					 | 
					
						 
 
					 | 
				 
				
					
						Fax
						Number 
					 | 
					
						 
 
					 | 
				 
				
					
						* Email
						Address 
Confirm
						that the email address is correct before continuing. The owner
						email address is not publicly viewable in the
						USPTO's TSDR database. 
					 | 
					
						 
 
The
						owner/holder is required to provide an email address and keep
						that address current with the USPTO. If the owner/holder is
						represented by a U.S.-licensed attorney, only the attorney's
						email address will be used for correspondence by 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 
					 | 
				 
			 
			 
			 
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			Goods/Services/Collective
			Membership Organization Information 
			 
WARNING: Registration
			Subject to Cancellation for Fraudulent Statements 
You
			must ensure that statements made in filings to the USPTO are
			accurate, as inaccuracies may result in the cancellation of a
			trademark registration. The
			lack of use on all goods/services, or to indicate
			membership in the collective organization for which you claim use
			in a post-registration filing with the USPTO 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: 
 
 
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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. 
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					 | 
					
						The
						filing does not cover
						this specific class. This entire class is to be
						permanently deleted from
						the registration. WARNING: This class will be permanently
						deleted from the registration and may NOT be reinserted. 
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 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. 
 
 
LEAVE
						THIS SPACE BLANK IF THIS FILING COVERS ALL GOODS/SERVICES,
						OR INDICATES MEMBERSHIP IN THE COLLECTIVE ORGANIZATION IN THE
						EXISTING REGISTRATION FOR THIS SPECIFIC CLASS. LIST ONLY THE
						GOODS/SERVICES TO BE DELETED (REMOVED). 
 
						 
					 | 
				 
				
					
						      Remaining
						Goods/Services: The mark
						is in use in commerce on or in connection with the following
						goods or services listed in the existing registration for this
						specific class: 
 
 
ENTER
						HOW THE COMPLETE "FINAL"
						LISTING SHOULD READ THAT WILL IDENTIFY THE GOODS/SERVICES WITH
						WHICH THE MARK IS IN USE IN COMMERCE FOR THIS SPECIFIC
						REGISTRATION (i.e.,
						ENTER THE LISTING WITH THOSE GOODS/SERVICES IDENTIFIED IN THE
						PRECEDING BOX REMOVED). WHILE YOU MAY MODIFY THE CURRENT
						LISTING EITHER TO CLARIFY OR LIMIT GOODS/SERVICES/THE NATURE OF
						THE COLLECTIVE MEMBERSHIP ORGANIZATION, OR TO REMOVE
						GOODS/SERVICES, YOU MAY NOT AT THIS POINT ADD TO, OR BROADEN,
						THE GOODS/SERVICES/NATURE OF THE COLLECTIVE MEMBERSHIP
						ORGANIZATION OR OTHERWISE AMEND THE GOODS/SERVICES/NATURE OF
						THE COLLECTIVE MEMBERSHIP ORGANIZATION BEYOND THE SCOPE OF THAT
						IN THE REGISTRATION. 
						 
						 
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			Use
			Information 
NOTE: If
			deleting an entire class, you may by-pass any fields listed as
			being "mandatory." 
		 | 
	
	
		
			*Specimen
			File: A specimen is
			required showing the mark in use in commerce for each class in the
			registration. 
 
Watch the TMIN
			instructional video on what is an appropriate trademark or service
			mark specimen for a good or service. 
 
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 or 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 specimen showing use of your mark on the goods or
			services in your registration: 
*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 
			 
 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 attached 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) 
 
 
			 
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						Attorney
						Information 
					 | 
				 
				
					
						* Attorney
						Name 
					 | 
					
						 
 
					 | 
				 
				
					
						Firm
						Name 
					 | 
					
						 
 
					 | 
				 
				
					
						Docket/Reference
						Number 
					 | 
					
						 
 
NOTE: You
						must limit your entry here to no more than 12 characters. 
					 | 
				 
				
					
						* Bar
						Membership 
					 | 
					
						 
						 
					 | 
				 
				
					
						* Year
						of Admission  
						                                                                                 
 
					 | 
				 
				
					
						* 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. 
					 | 
				 
			 
			 
			 
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			Correspondence
			Information 
			To
			make changes to the Primary
			Email Address for Correspondence below,
			either 
(1) return to 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 is used for official communication by
			the USPTO. The owner/holder or the owner's/holder's appointed
			attorney must keep this email address current. The owner/holder or
			the owner's/holder's appointed attorney may provide Secondary
			Email Addresses for receiving courtesy copies. 
		 | 
	
	
	
		
			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. 
		 | 
	
	
	
		
			
				
				
					| 
						
						  
						 
					 | 
				 
				
					
						
							
							
							
								
									Combined
									§§ 8 & 15 Filing Fee: $425 
								 | 
							 
							
								
									      Number
									of Classes 
								 | 
								
									   
								 | 
							 
							
								
									      Note: The
									filing fee is computed based on the Number of Classes in
									which the goods/services/collective membership organization
									associated with the mark is/are classified. 
								 | 
							 
							
								
									      Combined
									§§ 8 & 15 Filing Fee 
     
									(Number of Classes x $425 (per class)) 
								 | 
								
									 
$  
								 | 
							 
							
								
									Grace
									Period Fee: $100 
(if filing during the six month grace
									period, Section 8 Grace Period Fee is added) 
								 | 
							 
							
								
									      Grace
									Period Fee 
      (Number of Classes x
									$100 (per class)) 
								 | 
								
									 
$  
								 | 
							 
							
								
									Total
									Fee Paid 
(Note: The total fees paid is the sum of the
									Combined §§ 8 & 15 filing fee due and the
									grace period fee due, if applicable.) 
								 | 
							 
							
								
									        Combined
									§§ 8 & 15 Filing fee + Grace Period fee 
								 | 
								
									$  
								 | 
							 
						 
						 
						 
					 | 
				 
				
					| 
						
						  
						 
					 | 
				 
			 
			 
			 
		 | 
	
	
	
		
			
				
				
					
						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. 
								 | 
							 
							
								
									 
 
								 | 
								
									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. 
								 | 
							 
						 
						 
						 
					 | 
				 
			 
			 
			 
		 | 
	
	
	
		
			
				
				
				
				
				
					
						* 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 owners. 
					 | 
					
						* 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 
					 | 
					
						 
 
					 | 
				 
			 
			 
			 
		 | 
	
	
	
		
			STEP
			1: Review the application
			data in various formats, by clicking on the phrases under
			Application Data. Use the print function within your browser to
			print these pages for your own records. 
Note: It
			is important that you review this information for accuracy and
			completeness now. Corrections after submission may not be
			permissible, thereby possibly affecting your legal rights. 
			
				
			
			 
			 
		 | 
	
	
		
			 
 STEP
			2: If any of the information
			is incorrect, click on the Go Back to Modify button below to make
			changes; then re-validate using the Validate button at the bottom
			of the Combined Declaration of Use and Incontestability under
			Sections 8 & 15. If there are no errors and you are ready to
			file electronically, first use your print function within your
			browser to print each of these pages for your own records. Then,
			click on the Pay/Submit button below. This will bring up a screen
			for you to enter the appropriate payment information. After
			successful entry of the payment information, you will be able to
			complete the submission to the USPTO. 
		 | 
	
	
		
			 
 STEP
			3: If there are no errors
			and you are ready to file, confirm the Primary
			Email Address for Correspondence,
			displayed below. To make changes to this email address, use the
			navigation buttons below to return to the appropriate page in the
			form and update either the attorney's email address, if appointed,
			or the applicant owner's/holder's email address. Courtesy
			copies are also permitted
			and these email address(es) are displayed below. To update these
			addresses, use the navigation buttons below to return to the
			Correspondence Information page and enter the changes. 
 
After
			you submit the form, the USPTO will send an acknowledgment of
			receipt to the following email address(es): 
			
				
					
					
						
							
								
								
								
									
										Primary
										Email Address for Correspondence 
									 | 
									
										 
										 
									 | 
								 
								
									
										Secondary
										Email Address(es) (Courtesy Copies) 
									 | 
									
										 
										 
									 | 
								 
							 
							 
							 
						 | 
					 
				 
			
			 
			 
		 | 
	
	
		
			 
 STEP
			4: Read and check the
			following: 
			
				
					
					
						
							
								
								
									
										Important
										Notice: 
									 | 
								 
								
									
										(1)
										Once you submit a Combined Declaration of Use and
										Incontestability under Sections 8 & 15, either
										electronically or through the mail, we will not refund your
										fee, because it is a processing fee for our substantive
										review. 
(2) All information you submit to the USPTO at
										any point in the application and/or registration process
										will become public record, including your name, phone
										number, email address, and street address. By filing this
										document, you acknowledge and agree that YOU
										HAVE NO RIGHT TO CONFIDENTIALITY in
										the information disclosed. The public will be able to view
										this information in the USPTO's on-line databases and
										through internet search engines and other on-line
										databases. This information will remain public even if the
										application is abandoned or any registration is
										surrendered, cancelled, or expired. To maintain
										confidentiality of banking or credit card information, only
										enter payment information in the secure portion of the site
										after validating your form. For any information that may be
										subject to copyright protection, by submitting it to the
										USPTO, the filer is representing that he or she has the
										authority to grant, and is granting, the USPTO permission
										to make the information available in its on-line database
										and in copies of the application or registration
										record. 
(3) Be aware that private
										companies not associated
										with the USPTO often use trademark application and
										registration information from the USPTO's databases to mail
										or email trademark-related solicitations (samples
										of non-USPTO solicitations included). 
 
 
 If
										you have read and understand the above notice, please check
										the box before you click on the Pay/Submit button. 
									 | 
								 
							 
							 
							 
						 | 
					 
				 
			
			 
			 
		 | 
	
	
		
			 
 STEP
			5: To download and save the
			form data, click on the Save
			Form button at the
			bottom of this page. The information will be saved to your local
			drive. To begin the submission process with saved data, you must
			open a new form, and click on the "Browse/Choose File"
			button displayed on the initial form wizard page, at "[OPTIONAL]
			To access previously-saved data, use the "Browse/Choose File"
			button below to access the file from your local drive."
			REMINDER: Do NOT try
			to open the saved .obj form directly. You must return to the very
			first page of the form, as if
			starting a brand new form, and
			then use the specific "Browse/Choose File" button on
			that page to import the saved file. Clicking on the "Continue"
			button at the bottom of that first page will then properly open
			the saved version of your form. 
		 | 
	
	
		
			 
 STEP
			6: If you are ready to file
			electronically: 
Click on the Pay/Submit button, below, to
			access the site where you will select one of three possible
			payment methods. After successful entry of payment information,
			you can complete the submission to the USPTO. A valid transaction
			will result in a screen that says SUCCESS! Also,
			we will send an email acknowledgment within 24
			hours. 
WARNING: Click
			on the Pay/Submit button below ONLY if
			you are now entirely prepared to complete the Pay/Submit process.
			After clicking the button, you can NOT return
			to the form, since you will have left the TEAS site entirely. Once
			in the separate payment site, you must complete the Pay/Submit
			process within 30 minutes. If you are not prepared to complete the
			process now, you should select the "Save Form" option to
			save your form, and then complete the Pay/Submit process later.
			Or, if you have discovered any error, use the "Go Back to
			Modify" button to make a correction. 
WARNING: You
			can NOT make
			any fee payments by credit
			card from 2 a.m. to 6 a.m.
			Sunday ET. To file during this specific period, you must use
			either the deposit account or electronic funds transfer payment
			method; or, you may use the "Save Form" option to save
			your form, and then complete the Pay/Submit process at a later
			time with the credit card payment option. 
		 | 
	
PRA
Burden Statement
A Federal
agency may not conduct or sponsor, and a person is not required to
respond to, nor shall a person be subject to a penalty for failure to
comply with an information collection subject to the requirements of
the Paperwork Reduction Act of 1995, unless the information
collection has a valid OMB Control Number. The OMB Control Number for
this information collection is 0651-0055. Public burden for this form
is estimated to average 10 minutes per response, including the time
for reviewing instructions, searching existing data sources,
gathering and maintaining the data needed, and completing and
reviewing the information collection. Send comments regarding this
burden estimate or any other aspect of this information collection,
including suggestions for reducing this burden to the Office of the
Chief Administrative Officer, United States Patent and Trademark
Office, P.O. Box 1450, Alexandria, VA 22313-1450 or email
InformationCollection@uspto.gov.
Privacy
Act Statement
The USPTO
collects this information under authority of 35 U.S.C. 2(b)(2). The
information you provide will be used to process your applications and
submissions related to trademark registration. The information in
this system of records is used to manage name, citizenship, domicile,
email address, postal address, and telephone number of the trademark
applicant, registrant, and applicant’s or registrant’s
legal or other authorized representative(s), an attorney’s law
firm or company affiliation and professional licensing information,
and other information pertaining to an applicant’s or
registrant’s activities in connection with the applied-for or
registered mark. The information is protected from disclosure to
third parties in accordance with the Privacy Act. However, routine
uses of this information may include disclosure to the following: the
public; certain foreign entities, professional organizations or
associations, audit or oversight controls; law enforcement;
non-federal personnel working for the agency; record and
informational inquiries; coordinators of data breach response;
litigation actions; Department of Justice; Office of Personnel
Management; Congressional inquiries; the National Archives and
Records Administration; and Office of Management and Budget. If you
do not furnish the requested information, the U.S. Patent and
Trademark Office may not be able to process and/or examine your
submission, which may result in termination of proceedings or
abandonment of the application for trademark registration. The
applicable Privacy Act System of Records Notice for this information
request is COMMERCE/USPTO-26, Trademarks Application and Registration
Records: Federal Register vol. 85 February 18, 2020, p 8847,
available at https://
www.govinfo.gov/content/pkg/FR-2020-02-18/pdf/2020-03068.pdf.
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document | 
| Author | Smalls, Jonya | 
| File Modified | 0000-00-00 | 
| File Created | 2024-12-11 |