WWW.BUSINESSREGISTRATIONS.COM FORM T-3 01/2017 Nonrefundable Filing Fee: $50.00 STATE OF HAWAII DEPARTMENT OF COMMERCE AND CONSUMER AFFAIRS Business Registration Division 335 Merchant Street Mailing Address: P.O. Box 40, Honolulu, Hawaii 96810 Phone No. (808) 586-2727 *T3* APPLICATION FOR REGISTRATION OF SERVICE MARK (Chapter 482, Hawaii Revised Statutes) PLEASE TYPE OR PRINT LEGIBLY IN BLACK INK 1. Applicant's Name:______________________________________________________________________________________________________ Business Address: ____________________________________________________________________________________________________ (including city, state, and zip code) 2. 3. Registration is (check one): New OR Renewal (Certificate No. ____________________) Corporation Partnership LLC LLP Status of Applicant (check only one): Unincorporated Association OR Sole Proprietor Other (explain): ________________________________________________________________ 4. 5. If applicant is an entity, list state or country of incorporation/formation/organization: __________________________________________________ Service Mark is specifically described as: ____________________________________________________________________________________ _____________________________________________________________________________________________________________________ 6 Service mark is being used in connection with the following services: ______________________________________________________________ ____________________________________________________________________________________________________________________ 7. State the mode or manner in which the service mark is being used in connection with the services provided: ______________________________ _____________________________________________________________________________________________________________________ 8. State the classification for this service mark: _________________________________________________________________________________ (See instructions on reverse side - only one classification per application allowed) Date mark first used anywhere: ________________________________; Date mark first used in Hawaii: _________________________________ I am the applicant OR 9. I certify, under the penalties set forth in Section 482-51, Hawaii Revised Statutes, that (check one): I am the _______________________________________ of the applicant named in the foregoing application, that the applicant is the owner of the (Office Held) mark, that I am authorized to sign this application, and to the best of my knowledge and belief, the mark has been and is still in use, that no other person has registered, either federally or in this State, or has the right to use, the mark either in the identical form thereof or in such near resemblance thereto as to be likely, when applied to the services of the other person, to cause confusion, to cause mistake, or to deceive, and that the above statements are true and correct. ________________________________________ (Print Name) _____________________________________________ (Signature) _____________________________ (Date) SEE INSTRUCTIONS ON REVERSE SIDE ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------(DEPARTMENTAL USE ONLY) Certificate of Registration No. _____________________ CERTIFICATE OF REGISTRATION OF SERVICE MARK In accordance with the provisions of Chapter 482, Hawaii Revised Statutes, this Certificate of Registration is issued to secure the aforesaid applicant the use of the said SERVICE MARK throughout the State of Hawaii for the term of five years from __________________________________________ to _____________________________________________ . DEPARTMENT OF COMMERCE AND CONSUMER AFFAIRS STATE OF HAWAII REGISTRATION OF A SERVICE MARK WITH THE DEPARTMENT DOES NOT GRANT YOU OWNERSHIP OF THE SERVICE MARK Dated: __________________________________________________________ ________________________________________________________________ (Director of Commerce and Consumer Affairs) American LegalNet, Inc. www.FormsWorkFlow.com B48 (Fee) S18 (SH) WWW.BUSINESSREGISTRATIONS.COM FORM T-3 01/2017 Nonrefundable Filing Fee: $50.00 INFORMATION FOR APPLICANTS FOR REGISTRATION OF SERVICE MARKS REGISTRATION OF A SERVICE MARK WITH THE DEPARTMENT DOES NOT GRANT YOU OWNERSHIP OF THE SERVICE MARK. Section 482-22, Hawaii Revised Statutes, provides that an applicant for registration of service mark must file an application with the Director of Commerce and Consumer Affairs, verifying that the applicant is the owner of the service mark. Ownership of a service mark is acquired by adoption and use of the service mark. Before filing an application, an applicant should check the computerized list of registered names to determine if there is a registration that is substantially identical to the service mark he wishes to register. A check should also be made in the telephone directory of each island, the city directory and with the Department of Taxation. When an application is filed, the Business Registration Division will make a search of the registrations on record to determine that there is no other registration that is the same or substantially identical to the service mark applied for. Section 482-25, HRS, provides that the registration will be for a term of five years from the date of filing. Registrations may be renewed for additional periods of five years from the date of renewal by filing an application and $50.00 fee within six months prior to the expiration date. Section 482-28.5, HRS, provides that if, after registration with the Director of Commerce and Consumer Affairs, the service mark is abandoned or not used by the registrant for any period of 365 consecutive days, the service mark shall be subject to revocation. Any person desiring such revocation is required to file a verified petition with the Director requesting revocation of the service mark and setting forth facts indicating abandonment or nonuse by the registrant for a period of 365 consecutive days immediately preceding the date of filing of the petition. After granting an opportunity for hearing to the petitioner and registrant, the Director shall grant or deny the petition as the facts shall warrant. Section 482-28.5, HRS, provides that any person claiming to be the owner of a service mark for which a certific