State of California
Secretary of State
REGISTRATION OF TRADEMARK OR SERVICE MARK
Pursuant to Business and Professions Code Section 14207
IMPORTANT Read instructions before completing this form.
REGISTRATION APPLICATION FOR: 1. REGISTRANT NAME 2. BUSINESS ADDRESS 3. BUSINESS STRUCTURE (Check One)
CORPORATION (State of Incorporation)____________________________ LIMITED LIABILITY COMPANY (State of Organization) ____________________________ LIMITED PARTNERSHIP (State of Organization) ____________________________ GENERAL PARTNERSHIP (State of Organization) ____________________________ CITY AND STATE ZIP CODE
SPOUSES, AS COMMUNITY PROPERTY
DOMESTIC PARTNERS, AS COMMUNITY PROPERTY OTHER (Describe)_________________________________
4. NAMES OF GENERAL PARTNERS, IF REGISTRANT IS A PARTNERSHIP 5. NAME AND/OR DESIGN OF MARK. (For design, provide a brief written description that can be pictured in the mind without reference to the
specimens. Do not draw the design on the application. Attach a drawing of the mark.)
6. DISCLAIMER (If Applicable) NO CLAIM IS MADE TO THE EXCLUSIVE RIGHT TO USE THE TERM:
7a. DATE THE MARK WAS FIRST USED IN CALIFORNIA
DATE THE MARK WAS FIRST USED ANYWHERE
8a. IF A TRADEMARK, LIST SPECIFIC GOODS. IF A SERVICE MARK, LIST SPECIFIC SERVICE.
THIS SPACE FOR FILING OFFICER USE TRADE/SERVICE MARK REG. NO. _______________________ CLASS NO.(S) ___________________
8b. CLASS NUMBER(S)
9. RETURN ACKNOWLEDGMENT TO: (Type or Print) NAME ADDRESS CITY/STATE/ZIP
FILING FEE: $70.00 PER CLASSIFICATION
SEC/STATE TM 100 (REV. 07/08)
10. PLEASE INDICATE WHETHER AN APPLICATION TO REGISTER THE MARK, OR PORTIONS, OR A COMPOSITE THEREOF, HAS BEEN FILED BY
THE REGISTRANT OR A PREDECESSOR IN INTEREST WITH THE UNITED STATES PATENT AND TRADEMARK OFFICE. FILING DATE _________________ SERIAL/FILE NO. ___________________ STATUS OF APPLICATION _____________________________ IF REFUSED, WHY? _______________________________________________________________________________________________
11. MANNER IN WHICH THE MARK IS USED (Check all that apply)
FOR TRADEMARKS ONLY ON LABELS AND TAGS AFFIXED TO THE GOODS ON LABELS AND TAGS AFFIXED TO CONTAINERS OF THE GOODS BY PRINTING IT DIRECTLY ONTO THE GOODS BY PRINTING IT DIRECTLY ONTO THE CONTAINERS OF THE GOODS OTHER ________________________________________________ FOR SERVICE MARKS ONLY ON BUSINESS SIGNS ON ADVERTISING BROCHURES ON ADVERTISING LEAFLETS ON BUSINESS CARDS ON LETTERHEADS ON MENUS OTHER __________________________
12. SPECIMENS (Check one box below and enclose three (3) identical original specimens)
FOR TRADEMARKS ONLY ACTUAL LABELS ACTUAL TAGS PHOTOGRAPHS OF GOODS/CONTAINERS SHOWING THE TRADEMARK FRONT PANELS OF A PAPER CONTAINER BEARING THE TRADEMARK OTHER ________________________________________________ FOR SERVICE MARKS ONLY BUSINESS CARDS ADVERTISING BROCHURES ADVERTISING LEAFLETS MENUS SHOWING THE MARK OTHER ________________________
13. DECLARATION OF OWNERSHIP Applicant declares that the applicant is the owner of the mark, that the mark is in use, and that to the knowledge of the person verifying the application, no other person has registered in this state, or has the right to use the mark, either in the identical form or in such near resemblance as to be likely, when applied to the goods or services of the other person, to cause confusion, to cause mistake, or to deceive.
14. DECLARATION OF ACCURACY Applicant declares that all the information contained in this registration is accurate and if the applicant willfully states in the registration any material fact that the applicant knows to be false, the applicant shall be subject to a civil penalty of not more than ten thousand dollars ($10,000.00).
SIGNATURE OF AUTHORIZED PERSON
TYPE OR PRINT NAME AND TITLE
INSTRUCTIONS FOR COMPLETING REGISTRATION OF TRADEMARK/SERVICE MARK
Type or print in blue or black ink. Submit a "drawing" of your mark on an 8 ½" x 11" sheet of paper with your application, specimens, and the filing fee of $70.00 per classification. Mail your application to Secretary of State, Trademark Unit, P.O. Box 942877, Sacramento, CA 94277-0001.
Item 1. Item 2. Item 3. Enter the complete name of the owner of the mark. Enter the complete business address of the owner of the mark. Identify the business structure of the registrant by checking the appropriate box. If a corporation, limited liability company, limited partnership or general partnership is the owner of the mark, list the state of origination. Enter the names of the general partners, if registrant is a partnership. If the mark is just "words", please list only those words. If the mark is words and a design, provide the words and a brief written description of the design. If the mark is a design only, please provide a brief written description of the design in the space provided without making any reference to the specimens. Do not paste, tape, or staple a specimen in this space. Do not adhere anything to the application. If the mark or any part of the mark is not in English, you must submit a "certified translation" with your application. Disclaimer if the mark includes a descriptive word or design, it must be disclaimed. A disclaimer is an acknowledgment by the registrant that words that are "merely descriptive" may not be owned by anyone. The mark must be in use in California prior to registration. Enter the date the mark was first used in California and the date the mark was first used anywhere. If a trademark, the goods or products must have actually been sold or otherwise distributed in California. If a service mark, the advertised services must actually be rendered in California. The mere advertising of future services or goods does not constitute use of a trademark or service mark. Enter the specific goods or services and the classification number(s). To view the listing of classifications of goods and services, please visit the United States Patent & Trademark office at http://www.uspto.gov/web/offices/tac/doc/basic/international.htm, or at 37 Code of Federal Regulations, part 6, section 6.1. If a trademark, list only the specific products or goods on which the mark is used. Do not use general terms. Be specific. If a service mark, list only the specific services provided. Do not use general terms. Be specific. If more than one classification of goods or services are listed, a $70.00 filing fee is required for each classification. Enter the classification number(s) for the goods or services listed. Enter the name and address of the person or firm to receive the certificate of registration. If you or a predecessor in interest, have attempted to file your mark at the United States Patent and Trademark office, please provide all pertinent information regarding registration or refusal to register. Indicate the use of the mark. How is the mark used? If a trademark, how is it applied to the goods or products? By label, tag, or imprinting on the goods or their containers? If a service mark, how is the mark used, in advertising, on brochures, or business cards? Include with the application three identical (meaning: three of the same) original specimens that show how the mark is used on the goods or in connection with services identified in the application. The specimens should be no larger than 8 ½" x 11" and should lay flat. Specimens that have been altered or defaced in any manner are not acceptable. Do not submit metal of any kind, words typed on cards or sheets of paper. Computer generated prototypes are not acceptable. If a trademark, submit specimens that are affixed to your goods or products. Labels, tags, wrappers, or three clear identical photographs of the goods or products showing the mark clearly affixed. If a service mark, submit specimens from which the type of services provided can be determined. Envelopes, invoices and matchbooks are not acceptable as specimens. Business cards, brochures, flyers, or advertisements are acceptable if identifying the nature of the service rendered by applicant. Declaration of Ownership. The registrant must be the owner of the mark and make a declaration of ownership. Declaration of Accuracy. The registrant must make a declaration of accuracy and will be subject to a civil penalty of not more than $10,000.00 for willfully stating in the registration any material fact known to be false. Please date, sign, and print the name of the person signing the application. If the registrant is a corporation, limited liability company, or partnership, please list the title of the person signing the application.
Item 4. Item 5.
Item 9. Item 10. Item 11.
Item 13. Item 14.