CSCL/CD-600 (Rev. ) MICHIGAN DEPARTMENT OF LICENSING AND REGULATORY AFFAIRSCORPORATIONS, SECURITIES & COMMERCIAL LICENSING BUREAU Date Received(FOR BUREAU USE ONLY) MARK IDENTIFICATION NUMBER Pursuant to the provisions of Act 242, Public Acts of 1969, as amended, the undersigned executes the following application: 1.This application is for the purpose of registering a: (Check only one)2.The Mark consists of: (Complete only one)This registration will expire 10 years from thestamped registration date.APPLICATION FOR REGISTRATION OF TRADEMARK/SERVICE MARK(Please read information and instructions on last page) Trademark Service Mark a)Words Only:The words in the mark are:b)Design Only:The detailed description of the design is:c)Words and Design:The word(s) used in the mark are:The detailed description of the design is:Please note: Item 3 should be completed for registration of a trademark, and item 4 should be completed for registration of a service mark.Only one mark and one classification may be used per application. 3.Trademarksa)List the good(s) in connection with which the mark is used.b)List the mode or manner in which the trademark is used in connection with the good(s).c)Numerical classification of good(s):(Select only one class) American LegalNet, Inc. www.FormsWorkFlow.com CSCL/CD-600 (Rev. ) 4.Service Marksa)List the service(s) in connection with which the mark is used.b)List the mode or manner in which the service mark is used in connection with the service(s).c)Numerical classification of service(s): (Select only one class) 5.Date and place of first use:a)The date the mark was first used in Michigan: b)The city in which the mark was first used in Michigan: Complete items c and d if used anywhere else prior to the date in item a.c)The date the mark was first used anywhere: d)The city, state, and country where the mark was first used:City: State: Country: 6.Applicanta)The name of the individual or business entity applying for registration is: (Only one name should be provided)b)The business address of the applicant is:Complete item 7 only if the applicant name in item 6a is a corporation. 7.The state of incorporation: 8.The application must be accompanied by 2 samples of the mark, as used at the time of application. The samples should be 8.5 x 11inches or smaller so they may be scanned into the Corporation Division's database.State ofCounty of {SS I, being first sworn, hereby depose and say that I have read the above application, including any attached papers, and the facts set out thereinare true; the applicant is the owner of the mark and none other has the right to use the mark in Michigan either in the identical form or in aform which o nearly resembles the mark as to be likely to deceive or to be mistaken for the mark; the samples of the mark as filed herewith aretrue and correct. FURTHER, the Michigan Department of Licensing and Regulatory Affairs, Corporations, Securities & Commercial LicensingBureau, is hereby appointed as the applicant's agent for service of process only in actions relating to the registration or application for registration of this mark. SignatureType or Print NameType or Print TitleSubscribed and sworn to before me this day of, . My Commission ExpiresState ofNotary Public forcounty, (Type or Print Name of Notary) (Signature of Notary) American LegalNet, Inc. www.FormsWorkFlow.com Limited Liability Company - by a manager if management is vested in one or more managers, by a member if management is reserved for members, or an authorized agent of the company. Submit with check or money order by mail: Michigan Department of Licensing and Regulatory Affairs Corporations, Securities & Commercial Licensing Bureau Corporation Division P.O. Box 30054 Lansing, MI 48909To submit in person:2501 Woodlake CircleOkemos, MI 48864Telephone: (517) 241-6470 Fees may be paid by check, money order, VISAMasterard when delivered in person to our office. LARA is an equal opportunity employer/program.Auxiliary aids, services and other reasonable accommodations are available upon request to individuals withdisabilities. 5.Item 2 - Complete section (a), (b) or (c) depending on the type of mark that is being registered.11.FEES: Make remittance payable to the State of Michigan...............................................................................................................$50.00INFORMATION AND INSTRUCTIONS1. This pplication must be used to register a Trademark/Service Mark. A document required or permitted to be filed under this Act cannot be filed unless it contains the minimum information required by the ActThis is a legal document and agency staff cannot provide legal advice. CSCL/CD-600 (Rev. )Preparer's NameBusiness telephone number( )10.This application must be signed by: Individual - by the applicant. Corporation - by an authorized officer or agent. - by a partner. 9. Item 8 - Two copies, photographs, facsimiles or specimens of the mark, as actually in use must accompany thisApplication. The sample should be 8.5 x 11 inches or smaller so it may be maintained on electronic format. 8. Item 5 - A trademark is considered "used in Michigan" when affixed to the product container, tags, or labels and sold inMichigan. For services, the mark must be used or displayed in this state in the sale or advertising of services renderedin Michigan. 7.Service marks only: Item 4(a) - List the service(s) in connection with which the mark is used. Item 4(b) - List how the mark is used i.e. in advertising, signs, letterhead, etc. Item 4(c) - List the classification of the service(s), but be aware that only one classification can be designated perapplication. i. A list of the classification codes can be found on the last page. 6.Trademarks only: Item 3(a) - List the good(s) on which the mark is used. Item 3(b) - List how the mark is used i.e. in good(s) i.e. tag, label, etc. Item 3(c) - List the classification of the good(s), but be aware that only one classification can be designated perapplication. i. A list of the classification codes can be found on the last page. 4.The Department of Licensing and Regulatory Affairs, Corporations, Securities & Commercial Licensing Bureau is appointed as theapplicant's agent for service of process in actions relating to the registration or application for registration if: (1) the applicant is orbecomes a nonresident individual, partnership or association, (2) the applicant is or becomes a foreign corporation or limited liabilitycompany without a certificate of authority to transact business in Michigan, or (3) the applicant cannot be found in Michigan.3. This Application is to be used pursuant to Section 3(1) of Act 242, P.A. of 1969 for the purpose of registering a trademark or servicemark. A trademark is anyword, name, symbol, or device, or any combination thereof, other than a trade name in its entirety, adoptedand used by a person to identify goods made or sold by him or her and to distinguish them from similar goods made or sold by others.Similarly, a service mark is a mark used by a person in the sale or advertising of services to identify his or her services and distinguishthem from the similar services of others. The term person, as sed above, means an individual, firm, partnership, corporation,association, union, or other organization. A mark is not able to be registered until it has actually been adopted and used in Michigan.The registration is effective for ten years and is renewable for successive terms of 10 years upon the filing of an application for renewal,on a form provided by the Bureau, within six months prior to the expiration date. 2. Submit one original of this document. Upon filing, the Certificate of Registration will be mailed to the applicant or his/her representativeto the address provided on this Application. Since this application will be maintained on electronic format, it is important that the filingbe legible. Documents with poor black and white contrast, or otherwise illegible, will be rejected. American LegalNet, Inc. www.FormsWorkFlow.com TRADEMARK UNIFORM CLASSIFICATION OF GOODS1.Raw or partly prepared materials2.Receptacles3.Baggage, animal equipment, portfolios