TMA 58-01 kansas secretary of state Trademark Application Instructions Kansas Office of the Secretary of State: Memorial Hall, 1st Floor 120 S.W. 10th Avenue Topeka, KS 66612-1594 (785) 296-4564 kssos@sos.ks.gov www.sos.ks.gov The following form must be complete and accompanied by the correct filing fee or the document will not be accepted for filing. Stay up-to-date on your trademark or service mark status, expiration date, and contact address at www.sos.ks.gov. o Filing fee The filing fee for the application is $40. o Payment Please enclose a check or money order payable to the Secretary of State. Forms received without the appropriate fee will not be accepted for filing. Please do not send cash. NOTICE: There is a $25 service fee for all checks returned by your financial institution. Also, to expedite processing, please do not use staples on your documents or to attach checks. o Applicant information Complete the applicant’s name and address. The applicant may be an individual, company, association, union, or other organization. o Classification schedule Specify both number and class designation for the mark. At least one classification is required. See attached regulation. o Samples or specimens Submit three different samples of the mark. From the U.S. Patent and Trademark Office: “Usually, a specimen for a mark used on goods shows the actual goods, or labeling or packaging for the goods. For example, your specimen may be a tag or label displaying the mark, or a photograph showing the mark on the goods or packaging. The specimen may not be a “mock-up” of these items but must be a sample of what you actually use.” The specimens must be flat and no longer than 8½ x 12 inches. (ex: a label or photograph of packaging) o Duration of filing Unless earlier cancelled, a trademark has a term of five years from the date the application was filed with the Secretary of State. o Additional information Registration of the trademark with the Secretary of State is strictly optional. Kansas statutes expressly provide that registration does not affect the common law rights of others. Any right you might have to use a mark has been acquired through your use of the mark. If someone has prior use of the mark, registration will not give you any rights. Only your legal counsel can advise you about conflicting claims. Inst. K.S.A. 81-204 Rev. 04/25/11 jdr Please proceed to form. American LegalNet, Inc. www.FormsWorkFlow.com TMA 58-01 kansas secretary of state Trademark Application This form must be complete and accompanied by the correct filing fee or the document will not be accepted for filing. Stay up-to-date on your trademark or service mark status, expiration date, and contact address at www.sos.ks.gov. THIS SPACE FOR OFFICE USE ONLY. 1. Applicant/owner name 2. Applicant/owner address Address will be used to send official mail from the Kansas Secretary of State’s Office. Do not leave blank. Attention Name Address City State Zip Country 3. Is applicant a corporation, limited liability company, limited partnership, limited liability partnership, or other business entity, or is applicant a partnership? o Corporation, LLC, LP, LLP, or other business entity (Proceed to Question 3a). o Partnership (Proceed to Question 3b). 3a. If applicant is a corporation, LLC, LP, LLP, or other business entity, give the state of organization. 3b. If applicant is a partnership, give the state of organization and the names of the general partners. 4. Briefly describe the goods used in connection with the mark. 5. Briefly describe how the mark is used in connection with such goods. 1/2 K.S.A. 81-204 Rev. 04/25/11 jdr Please continue to next page. American LegalNet, Inc. www.FormsWorkFlow.com 6. Number(s) and class(es) of good(s) See classification schedule attached. 7a. Date applicant began use of trademark in Kansas Month Day 7b. Date applicant began use of trademark anywhere Year Month Day Year 8. Has the applicant or predecessor in interest filed an application for the same mark or portions of the same mark with the U.S. Patent and Trademark Office? o Yes (Proceed to Question 8a). o No (Skip to Question 9a). 8a. If yes, give the filing date and serial number. 8b. What is the status of the application? o Accepted o Pending o Refused 8c. If refused, give reason. 9a. Provide the name of the mark. This is how the mark will be searched with the Kansas Secretary of State’s office. 9b. Describe in words the exact mark you wish to register. 10. Attach three different samples or specimens showing the mark as actively used. 11. The applicant is the owner of the mark. The mark is in use, and, to the knowledge of the person verifying the application, no other person has registered, either federally or in this state, or has the right to use such mark either in the identical form thereof or in such near resemblance thereto as to be likely, when applied to the goods of such other person, to cause confusion, or to cause mistake, or to deceive. 12. I state that I am the applicant, a member of the firm applying, or an officer of the corporation or association applying, and declare under penalty of perjury that the foregoing application is true and correct. Signature of Applicant / Owner X Month Day Year Name of Applicant / Owner (printed or typed) Phone Number 2/2 K.S.A. 81-204 Rev. 04/25/11 jdr Please review to ensure completion. American LegalNet, Inc. www.FormsWorkFlow.com TMA 58-01 kansas secretary of state Trademark Application Attachment Kansas Office of the Secretary of State: Memorial Hall, 1st Floor 120 S.W. 10th Avenue Topeka, KS 66612-1594 (785) 296-4564 kssos@sos.ks.gov www.sos.ks.gov n International Schedule of Classes of Goods Class 1 (Chemicals): Chemicals used in industry, science and photography, as well as in agriculture, horticulture and forestry; unprocessed artificial resins; unprocessed plastics; manures; fire extinguishing compositions; tempering and soldering preparations; chemical substances for preserving foodstuffs; tanning substances; adhesives used in industry. Class 2 (Paints): Paints, varnishes, lacquers; preservatives against rust and against deterioration of wood; colorants; mordants; raw natural resins; metals in foil and powder form for painters, decorators, printers and artists. Class 3 (Cosmetics and cleaning preparations): Bleaching preparations and other substances for laundry use; cleaning, polishing, scouring and abrasive preparations; soaps; perfumery, essential oils, cosmetics, hair lotions; dentifrices. Class 4 (Lubricants and fuels): Industrial oils and greases; lubricants; dust absorbing, wetting and binding compositions; fuels (including motor spirit) and illuminants; candles and wicks for lighting. Class 5 (Pharmaceuticals): Pharmaceutical and veterinary preparations; sanitary preparations for medical purposes; dietetic substances adapted for medical use, food for babies; plasters, materials for dressings; material for stopping teeth, dental wax; disinfectants; preparations for destroying vermin; fungicides, herbicides. Class 6 (Metal Goods): Common metals and their alloys; metal building materials; transportable buildings of metal; materials of metal for railway tracks; nonelectric cables and wires of common metal; ironmongery, small items of metal hardware; pipes and tubes of metal; safes; goods of common metal not included in other classes; ores. Class 7 (Machinery): Machines and machine tools; motors and engines (except for land vehicles); machine coupling and transmission components (except for land vehicles); agricultural implements other than hand-operated; incubators Att. K.S.A. 81-204 Rev. 01/28/11 jdr for eggs. Class 8 (Hand tools): Hand tools and implements (handoperated); cutlery; side arms; razors. Class 9 (Electrical and scientific apparatus): Scientific, nautical, surveying, photographic, cinematographic, optical, weighing, measuring, signalling, checking (supervision), lifesaving and teaching apparatus and instruments; apparatus and instruments for conducting, switching, transforming, accumulating, regulating or controlling electricity; apparatus for recording, transmission or reproduction of sound or images; magnetic data carriers, recording discs; automatic vending machines and mechanisms for coin operated apparatus; cash registers, calculating machines, data processing equipment and computers; fire extinguishing apparatus. Class 10 (Medical apparatus): Surgical, medical, dental, and veterinary apparatus and instruments, artificial limbs, eyes, and teeth; orthopedic articles; suture materials. Class 11 (Environmental control apparatus): Apparatus for lighting, heating, steam generating, cooking, refrigerating, drying, ventilating, water supply, and sanitary purposes. Class 12 (Vehicles): Vehicles; apparatus for locomotion by land, air, or water. Class 13 (Firearms): Firearms; ammunition and projectiles; explosives; fireworks. Class 14 (Jewelry): Precious metals and their alloys and goods in precious metals or coated therewith, not included in other classes; jewelry, precious stones; horological and chronometric instruments. Class 15 (Musical Instruments): Musical instruments. Class 16 (Paper goods and printed matter): Paper, cardboard and goods made from these materials, not included in other classes; printed matter; bookbinding material; photographs; stationery; adhesives for stationery or household purposes; artists’ materials; paint brushes; Use to respond to Question 6. American LegalNet, Inc. www.FormsWorkFlow.com n International Schedule of Classes of Goods (Cont’d.) typewriters and office requisites (except furniture); instructional and teaching material (except apparatus); plastic materials for packaging (not included in other classes); printers’ type; printing blocks. Class 17 (Rubber goods): Rubber, gutta-percha, gum, asbestos, mica and goods made from these materials and not included in other classes; plastics in extruded form for use in manufacture; packing, stopping and insulating materials; flexible pipes, not of metal. Class 18 (Leather goods): Leather and imitations of leather, and goods made of these materials and not included in other classes; animal skins, hides; trunks and travelling bags; umbrellas, parasols and walking sticks; whips, harness and saddlery. Class 19 (Nonmetallic building materials): Building materials (non-metallic); nonmetallic rigid pipes for building; asphalt, pitch and bitumen; nonmetallic transportable buildings; monuments, not of metal. Class 20 (Furniture and articles not otherwise classified): Furniture, mirrors, picture frames; goods (not included in other classes) of wood, cork, reed, cane, wicker, horn, bone, ivory, whalebone, shell, amber, mother-of-pearl, meerschaum and substitutes for all these materials, or of plastics. Class 21 (Housewares and glass): Household or kitchen utensils and containers; combs and sponges; brushes (except paint brushes); brush-making materials; articles for cleaning purposes; steel-wool; unworked or semi-worked glass (except glass used in building); glassware, porcelain and earthenware not included in other classes. Class 22 (Cordage and fibers): Ropes, string, nets, tents, awnings, tarpaulins, sails, sacks and bags (not included in other classes); padding and stuffing materials (except of rubber or plastics); raw fibrous textile materials. Class 23 (Yarns and threads): Yarns and threads, for textile use. Class 24 (Fabrics): Textiles and textile goods, not included in other classes; beds and table covers. Class 25 (Clothing): Clothing, footwear, headgear. Class 26 (Fancy goods): Lace and embroidery, ribbons and braid; buttons, hooks and eyes, pins and needles; artificial flowers. Class 27 (Floor coverings): Carpets, rugs, mats and matting, linoleum and other materials for covering existing floors; wall hangings (non-textile). Att. K.S.A. 81-204 Rev. 01/28/11 jdr Class 28 (Toys and sporting goods): Games and playthings; gymnastic and sporting articles not included in other classes; decorations for Christmas trees. Class 29 (Meats and processed foods): Meat, fish, poultry and game; meat extracts; preserved, frozen, dried and cooked fruits and vegetables; jellies, jams, compotes; eggs, milk and milk products; edible oils and fats. Class 30 (Staple foods): Coffee, tea, cocoa, sugar, rice, tapioca, sago, artificial coffee; flour and preparations made from cereals, bread, pastry and confectionery, ices; honey, treacle; yeast, baking powder; salt, mustard; vinegar, sauces (condiments); spices; ice. Class 31 (Natural agricultural products): Agricultural, horticultural and forestry products and grains not included in other classes; live animals; fresh fruits and vegetables; seeds, natural plants and flowers; foodstuffs for animals; malt. Class 32 (Light beverages): Beers; mineral and aerated waters and other nonalcoholic drinks; fruit drinks and fruit juices; syrups and other preparations for making beverages. Class 33 (Wine and spirits): Alcoholic beverages (except beers). Class 34 (Smokers’ articles): Tobacco; smokers’ articles; matches. Use to respond to Question 6. American LegalNet, Inc. www.FormsWorkFlow.com