Trade and Service Marks - Registration Secretary of State - Corporation Division - 255 Capitol St. NE, Suite 151 - Salem, OR 97310-1327 - http://www.FilingInOregon.com - Phone: (503) 986-2200 REGISTRY NUMBER: For office use only In accordance with Oregon Revised Statute 192.410-192.490, the information on this application is public record. We must release this information to all parties upon request. For office use only Please Type or Print Legibly in Black ink. Attach additional Sheets if Necessary. 1) CORRESPONDENT NAME: 2) APPLICANT’S NAME: (Owner: MAILING ADDRESS: Individual or ADDRESS: Entity) 3) IF THE APPLICANT IS AN ENTITY, ENTER THE STATE OF FORMATION: 4) IF ENTITY IS A PARTNERSHIP, LIST NAMES OF GENERAL PARTNERS: 5) DESCRIPTION OF TRADE OR SERVICE MARK: (Include all words, designs and borders that comprise the mark) (Attach additional page if needed.) 6) SPECIMEN OF MARK IS REQUIRED: Attach a drawing or photocopy of the mark as it is actually used to this application. 7) GOODS OR SERVICES WITH WHICH THE MARK IS USED: (Examples of goods are pizzas, shirts; examples of services are serving food and selling clothing.) 8) EXPLAIN MODE OR MANNER IN WHICH THE MARK IS USED: (Example: on goods, tags, labels, containers, etc.) 9) CLASS NUMBER(S) OF GOODS OR SERVICES: (See form 290-a) 10) DATE MARK WAS FIRST USED ANYWHERE BY APPLICANT OR APPLICANT’S PREDECESSOR IN INTEREST: 11) DATE MARK WAS FIRST USED IN OREGON BY APPLICANT OR APPLICANT’S PREDECESSOR IN INTEREST: 12) EXECUTION: I, the applicant, own the mark, the mark is in use, and no other person has registered the mark with the federal government or in Oregon or has the right to use the mark or a mark that so resembles the mark as to be likely to cause confusion or mistake or deceive when applied to the goods or services of the other person. I declare under penalties of perjury that this application is true, correct and complete. (If applicant is an entity, a member of a firm, officer of the corporation, officer of the limited liability company, or officer of an association must sign.) Signature: CONTACT NAME: (To resolve questions with this filing.) Title: Date: FEES Required Processing Fee $50 PHONE NUMBER: (Include area code.) Processing Fees are nonrefundable. 290 - Trade and Service Marks - Registration (08/11) Please make check payable to “Corporation Division.” American LegalNet, Inc. www.FormsWorkFlow.com Classes of Goods and Services GOODS 101 Chemical Products used in industry; Artificial & Synthetic Resins; Plastics in the Form of Powders, Liquids or Paste; Fertilizers; Tanning & Adhesive Substances. Small Domestic Utensils & Containers; Combs, Sponges & Brushes (Other than Paint Brushes); Brush Making Materials; Glassware, Porcelain & Earthenware, not included in Other Classes. 122 Ropes, String & Nets; Canvas Products & Stuffing Materials. 123 Yarns & Threads. 124 Bed & Table Covers; Textile Articles not included in Other Classes. 125 Clothing & Footwear. 126 Garment Decorations & Buttons. 127 Floor Coverings & Non-textile Wall Hangings. 128 Toys; Sporting Articles (Except Clothing); Decorations. 129 Industrial Oils & Greases; Lubricants & Absorbing Compositions; Fuels & Illuminants. Furniture, Mirrors, Picture Frames; Articles (not included in other Classes) of Wood, Wicker, Ivory, Shell, Substitutes for all These Materials, or of Plastics. Meats; Fruits & Vegetables (Except Fresh); Dairy Products; Jams; Oils; Fats; Preserves & Pickles. Laundry, Cleaning & Polishing Substances; Cleansing & Cosmetic Items; Perfumery & Essential Oils. 104 120 Paints, Varnishes & Lacquers; Coloring Matters & Natural Resins. 103 Building & Road Materials; Stone, Stone Products; Cement & Earthenware Pipes. 121 102 119 105 106 107 Pharmaceutical, Veterinary & Sanitary Substances; Infants’ & Invalids Food; Bandaging Material; Dental Wax; Disinfectants & Weed Killers. Metal & Articles Made from Metal & Not included in Other Classes. Machines & Machine Tools; Motors (Except for Land Vehicles); Large Size Agricultural Implements; Incubators. 108 Hand Tools & Cutlery 109 Scientific, Nautical, Surveying & Electrical Apparatus & Instruments; Photographic, Cinematographic, Optical, Lifesaving, & Teaching Apparatus; Cash Registers & Calculating Machines. 110 Surgical, Medical, Dental & Veterinary Instruments & Apparatus. 130 Installations for Lighting, Heating, Steam Generating, Cooking, Refrigerating, Drying, Ventilating, Water Supply & Sanitary Purposes. Coffee, Tea, Cocoa & Coffee Substitutes; Rice, Tapioca, Sago, Flour, Cereals, Yeast, Baking Powder & Condiments, Breads, Pastry, Confectionary & Honey. 131 Agricultural, Horticultural, Forestry Products & Grains not included in Other Classes; Living Animals, Plants & Flowers; Fruits, Vegetables & Seeds; Foodstuffs for Animals. 111 112 Vehicles. 113 Firearms, Ammunitions, & Fireworks. 114 Precious Metals & Jewelry. 132 Beer & Nonalcoholic Drinks. 115 Musical Instruments & Supplies; Phonographs, Recording Tapes, Records, & Tape Recorders. 133 Wines, Spirits & Liqueurs. 134 Tobacco & Smokers’ Articles. 116 Paper Articles & Bookbinding Materials; Printed Matter, Photographs & Stationary; Artists’ Materials & Paint Brushes; Instructional & Teaching Material. 117 Plastics in the Form of Sheets, Blocks & Rods; Packing or Insulating Materials; Hose Pipes (Non-metallic). SERVICES 118 Leather, Imitations & Articles Made from Both & not included in Other Classes; Skins & Hides; Travel Gear, Umbrellas & Walking Sticks; Saddlery. 290-a - Classes of Goods and Services - (08/11) 135 136 137 138 139 140 141 142 Advertising & Business. Insurance & Financial. Construction & Repair. Communication. Transportation & Storage. Material Treatment. Education & Entertainment. Miscellaneous. American LegalNet, Inc. www.FormsWorkFlow.com