Application For Registration Of A Trademark Or Service Mark Form. This is a Virginia form and can be use in Trademark Secretary Of State.
Tags: Application For Registration Of A Trademark Or Service Mark, TM 1, Virginia Secretary Of State, Trademark
TM 1 (7/99) COMMONWEALTH OF VIRGINIA STATE CORPORATION COMMISSION APPLICATION FOR REGISTRATION OF A TRADEMARK OR SERVICE MARK (Please type or print) Applicant (owner) name and address:____________________________________________________________________ __________________________________________________________________________________________________ Contact person name and address:_______________________________________________________________________ ______________________________Daytime phone:_______________________ Fax number:______________________ Applicant is a:_______________________________Applicant's state or jurisdiction of formation: ___________________ (entity type i.e. corporation, partnership, etc) Kind of mark (check one): Trademark ___ Service Mark ___ Identify the trademark or service mark (or attach an exhibit of the exact mark): __________________________________ __________________________________________________________________________________________________ Class number(s) of goods or services (see 21 VAC 5-120-100):________________________________________________ Describe the product(s) or service(s) the mark represents (identifies):___________________________________________ __________________________________________________________________________________________________ Date mark was first used anywhere by applicant or applicant's predecessor: _____________________________________ Date mark was first used in Virginia by applicant or applicant's predecessor: ____________________________________ PLEASE NOTE: A specimen of the mark must accompany this application. The applicant asserts that it is the owner of this mark and that the mark is in use in the Commonwealth of Virginia. No other person has registered this mark or has the right to use this mark in Virginia, either in the identical form thereof or in such near resemblance thereto as to be likely, when applied to the goods or services of such person, to cause confusion or mistake, or to deceive. (NOTE: The application must be signed in the name of the applicant, either by the applicant or by a person authorized by the applicant. The application must be sworn to by the person who signed the name of the applicant.) Signature:___________________________________________________________Date: __________________________ Signer’s Name:_______________________________________________________Title:__________________________ (print or type) State of:_____________________________________, County/City of:___________________________________, to-wit: The foregoing application was subscribed and sworn to before me by __________________________________________ on the ___________________________ day of ______________________________, ____. My Commission Expires:_______________________________ Notary Public: __________________________________ American LegalNet, Inc. www.USCourtForms.com