OFFICE OF SECRETARY OF STATE CORPORATIONS DIVISION Suite 315, West Tower, 2 Martin Luther King Jr., Drive Atlanta, Georgia 30334-1530 (404) 656-2861 Trademark Search and Status Information on the Internet http://www.sos.state.ga.us/corporations/marksearch.htm KAREN HANDEL Secretary of State RENEWAL APPLICATION TRADEMARK OR SERVICE MARK Filing Fee $15.00 IN COMPLIANCE WITH THE REQUIREMENTS OF O.C.G.A. §10.1-446, THE UNDERSIGNED, HAVING ADOPTED AND USED A TRADEMARK OR SERVICE MARK IN THIS STATE FOR PURPOSES PROVIDED IN THE CODE CHAPTER, DOES HEREBY CERTIFY THE FOLLOWING: 1. _______________________________________________________________________________________________________ CURRENT REGISTERED OWNER 2. _______________________________________________________________________________________________________ PRINCIPAL BUSINESS ADDRESS 3. _______________________________________________________________________________________________________ DESCRIPTION OF MARK A) _____________________________ REGISTRATION NUMBER B) _____________________________ INITIAL REGISTRATION DATE IN MAKING THIS RENEWAL APPLICATION, THE UNDERSIGNED CERTIFIES THAT THE MARK HEREIN MENTIONED REMAINS IN USE IN THE STATE OF GEORGIA AND HAS NOT BEEN CHANGED IN THE PAST 10 YEARS; AND THE GOODS OR SERVICES OFFERED UNDER THE MARK REMAIN THE SAME AS IN THE ORIGINAL REGISTRATION. SIGNATURE OF OWNER ____________________________________________________ PRINT OR ____________________________________________________ TYPE NAME ____________________________________________________ OFFICIAL TITLE (IF SIGNING FOR A CORPORATION OR OTHER SIMILAR ENTITY) ____________________________________________________ PHONE NUMBER STATE OF ______________________________ COUNTY OF ______________________________ SWORN TO AND SUBSCRIBED BEFORE ME THIS ______ DAY OF ________________19, __________________ _________________________________________ NOTARY PUBLIC MY COMMISSION EXPIRES ______________________________________ American LegalNet, Inc. www.FormsWorkflow.com