TMSM-02 Rev. 10/02 New Jersey Division of Revenue APPLICATION TO RENEW A REGISTERED TRADE OR SERVICE MARK This form may be used by applicants seeking to renew a registered State trade or service mark pursuant to NJSA 56. Applicants are responsible for strict adherence to all requirements as set forth in State law. Applications may be submitted anytime within six months prior to the expiration of the registration period. 1. Trade/Service Mark Number: (as assigned by the Treasurer and listed on the Certificate of Registration) 2. Classification Within Which the Goods or Services Fall: (as listed on the Certificate of Registration or Filed Registration Application Form) 3. Owner Information: a. Name: (must match the name shown on the Division of Revenue's records) b. Current Business Address: 4. Assignee Information: (if applicable, provide assignee name/address) a. Name: b. Address: 5. Signature(s) and Statement of Continued Use: (verification required) The owner attests that he or she is the owner of the mark, and that the mark is still in use in this State. __________________________________________ (Signature of Owner, or a Member of the Firm, or an Officer of the Corporation or Business Applying) __________________________________________ (Assignee, if Applicable) ___________________ (Date) ___________________ (Date) Subscribed and sworn to before me, ____________________________________, a Notary Public, this ______ day of ___________ A.D. 20 ____. ________________________________________ (Notary Public) Note: Attach a specimen showing the mark as actually used on or connection with the goods or services involved. American LegalNet, Inc. www.USCourtForms.com Rev 7/05 Information for completing FormTMSM-02 Type or machine print all information except signatures and file application in duplicate. Remittance/Fees: Check or money order signed and made payable to the New Jersey Division of Revenue must accompany the application. · Base Filing Fee a) $50.00 per filing (includes one classification) · Premium Service Surcharges: a) $15.00 additional per filing for expedited handling (8.5 business hour processing for items delivered over the counter) b) $100.00 additional per filing for same day service (same day processing for items delivered over the counter) Addresses: Regular service (regular mail) NJ Division of Revenue PO Box 453 Trenton, NJ 08646-0453 Expedited and same day service** NJ Division of Revenue 225 West State Street Trenton, NJ 08608-1001 **Delivery by messenger or in person only; Do not use USPS overnight delivery. THIS FORM SERVES TO SIMPLY FILE WITH THE TREASURER and DOES NOT REPLACE THE NEED FOR COMPETENT LEGAL ADVICE. American LegalNet, Inc. www.USCourtForms.com