Form 3301--General Information (Application/Renewal for License to Use Texas State Seal) The attached form is designed to meet minimal statutory filing requirements pursuant to the relevant code provisions. This form and the information provided are not substitutes for the advice and services of an attorney. Commentary Commercial use of the Texas state seal is governed by Section 17.08, Texas Business & Commerce Code and the secretary of state's administrative rules found in 1 Texas Administrative Code Chapter 72. Section 17.08 prohibits private or commercial use of the state seal of Texas unless the user applies to the secretary of state. Each licensee must display the license in a conspicuous manner in the business office. In addition to the application and license fees totaling $285, each licensee must pay to the state a royalty fee of three percent of the annual gross receipts related to the licensed use in excess of $5,000. Licensees are also required to submit quarterly reports to the secretary of state. Royalties must be submitted on a quarterly basis along with the report according to the following schedule: Quarter First (Jan 1-Mar 31) Second (Apr 1-Jun 30) Third (July 1-Sept 30) Fourth (Oct 1-Dec 31) Report Due April 15 July 15 October 15 February 15 Licensees must maintain records related to the use of the state seal, and the secretary of state may examine the records to determine the licensee's compliance with the state seal requirements, including royalty payments to the state. A license to use the state seal expires one year after the date of issuance and may be renewed. This form is designed for both new applications and renewals. Instructions for Form Preliminary Information: Select the appropriate box to indicate new or renewal application. Applicant Information: Include the applicant's legal name, along with any assumed names, i.e., d/b/a's. It is requested that a telephone number also be provided. Also provide information identifying the applicant's business organization, including business address, organizational structure, and jurisdiction of formation. A document on file with the secretary of state is a public record subject to public access and disclosure. When providing address or telephone information, use a business or post office box address rather than a residence address if privacy concerns are an issue. Use of State Seal: Specify the mode and manner of the intended use of the state seal. Describe both the goods or services with which the seal would be used (the mode) and the specific application of the seal in connection with the goods or services (the manner). The license does not extend to uses not stated in the application. The applicant is to be the sole user of the license. Usage by a subsidiary or related entity requires a separate license. Attachments: The following items must be included with the application: 1. An example of use. If the state seal will be used on goods, examples include specifications of the product to bear the state seal, such as an architectural drawing, engineer's draft to scale, sales brochure, or photograph. If the state seal will be used in connection with services, examples include a printers proof for advertising or a printout from a web page that has not yet been made public; and 1 American LegalNet, Inc. www.FormsWorkFlow.com Form 3301  2. $285 ($35 application fee plus $250 licensing fee). Execution: A person authorized to sign on behalf of the person or entity applying for a license to use the state seal must sign and date the application. Payment and Delivery Instructions: The total licensing and application fee for a new or renewal license to use the state seal is $285 ($35 application fee plus $250 licensing fee). Fees may be paid by personal checks, money orders, LegalEase debit cards or American Express, Discover, MasterCard, and Visa credit cards. Checks or money orders must be payable through a U.S. bank or financial institution and made payable to the secretary of state. Fees paid by credit card are subject to a statutorily authorized convenience fee of 2.7 percent of the total fees. The completed form, along with the filing fee and example of use, may be mailed to Registrations Unit, P.O. Box 13550, Austin, Texas 78711-3550; or delivered to the James Earl Rudder Office Building, 1019 Brazos, Austin, Texas 78701. The secretary of state will issue a license upon filing of a completed and approved application. Revised 03/15 Form 3301 2 American LegalNet, Inc. www.FormsWorkFlow.com Form #3301 Rev. 03/15 This space reserved for office use Submit to: SECRETARY OF STATE Registrations Unit P O Box 13550 Austin, TX 78711-3550 512-475-0775 512-475-2815 - Fax Filing Fee: $285 APPLICATION/RENEWAL FOR LICENSE TO USE TEXAS STATE SEAL New Application Renewal Applicant Information Legal Name: Assumed Name(s): (if any) Phone: Business Address: Street City State Zip Organizational Structure: Individual/Sole Proprietorship Limited Liability Company Corporation Partnership Other: If business organization, jurisdiction of formation: Use of State Seal Mode: Describe the goods or services with which the applicant will use the state seal. Manner: State how the state seal will be used, including the medium by which the state seal will be displayed. For example, embroidered on clothing, imprinted on belt buckles, displayed on website. Attachments The following items are included with this application: Example(s) of use; and $285 ($35 application fee plus $250 licensing fee). Execution Date: Signature of authorized representative for Applicant Printed or typed name and title Form 3301 3 American LegalNet, Inc. www.FormsWorkFlow.com