I. |
*Provide
the name and/or an image of the
design of your proposed mark. If
sending an image of the design
by email, the design should be
in JPG, JPEG, GIF or Pdf format. You
may also send us the image of the
design together with this completed
form by facsimile. |
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OR attach a file
from your computer that contains
an image of the design, if any: |
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II. |
If
you are not now commercially using
the mark, provide the date on which
you intend to use the mark commercially: |
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III. |
If you are now using the mark,
please provide:
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if
you are only using the mark solely
in intrastate commerce (that is,
only within a single state) the
date you first used the mark only
within that single state and the
name of that state (for example,
January 1, 2007 only in California) |
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if you are using the
mark in interstate commerce (that
is, in more than one state), the
date you first used the mark in interstate
commerce |
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IV. |
Have
you previously applied for the
same or similar mark with the United
States Patent & Trademark Office
or with a foreign trademark office? |
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V. |
Describe
the goods or services to which
your mark applies: |
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Our
Assurance of Confidentiality
Premier IP Protection, LLC hereby
agrees that any information pertaining
to invention(s), idea(s), and
the like provided by the owner(s)
of the mark named in this Trademark
Registration Disclosure Form
will not be revealed, used, disclosed,
sold, or transferred without
the express authorization of
the owner(s) of the mark, except
if required by court order.
For Premier IP Protection, LLC:

Walter S. Stevens, Esq.
Manager Member |
Trademark
Owner's
Statement
By submitting this Trademark
Registration Disclosure Form
and any other information pertaining
to the mark, I acknowledge that
Premier IP Protection, LLC is
accepting this information for
review purposes only. I
understand that any comments
that I receive based upon this
review are based upon a limited
analysis and is neither meant
nor understood to be a conclusive
legal opinion. Further,
I agree that Premier IP Protection,
LLC cannot be held responsible
for any recommendations based
upon the review of the information
herein and cannot be held responsible
for the return of any submitted
materials. Even if no
signature(s) for the owner(s)
of the mark is/are included in
the submitted form, I/we acknowledge
that the submission of this Trademark
Registration Disclosure Form
shall indicate my agreement to
this Trademark Owner’s
Statement.
** There is no need sign this form,
if returning this form online.
It will be assumed that the completed
form is from the individual whose
name appears above. |