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Application For Registration Of A Trademark Or Service Mark TM 1 - Virginia
| Application For Registration Of A Trademark Or Service Mark Form. This is a Virginia form and can be used in Trademark Secretary Of State . |
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Instructions for Completion of Application for Registration of a Trademark or Service Mark See Form TM1 Item 1 Applicant (owner name and address): The applicant is the individual or entity that owns the mark. The mark will be used to distinguish the goods or services of the owner from those provided by others. The name of the applicant (owner) may be determined by the entity type in Item 3. If the applicant is a partnership, both individuals must be listed as the owner and both must sign the application before a notary public. Contact person name and address: Name and address of person we may contact with any questions we may have. Please furnish an email address, if available. Applicant is a: Select one of the entity types below that best identifies the type of entity of the applicant. Also indicate the applicant's state or jurisdiction of formation: Corporation Limited Liability Partnership Non Public Corporation Corporation of the Commonwealth Limited Partnership Partnership Federal Agency Limited Liability Company Real Estate Investment Trust Federally Chartererd Savings Bank Local Government Authority Sole Proprietorship General Partnership Municipal Corporation State Agency Individual National Banking Association Unincorporated Association Other Kind of mark: Indicate whether you are requesting registration of the mark as a trademark or service mark. A trademark is any word, name, symbol, device or combination thereof, used by a manufacturer or merchant to identify its goods and distinguish them from others. (Example: brand names identifying goods such as Pepsi Cola for a soft drink). A service mark is any word, name, symbol, device of combination thereof, used by a manufacturer or merchant to identify its services and distinguish them from others. (Example: identifies services such as McDonald's for a restaurant service). Identify trademark or service mark (or attach an exhibit): Indicate what the mark is on this line. If the mark is comprised of words only, type or write the words here. If the mark also includes a design, symbol or image, attach an exhibit of the mark to the application. An exhibit is a blank piece of paper with an appearance of the mark only without extraneous markings. Class number(s) of goods or services: Indicate in which class you wish to register the mark. Classes are groupings or categories of goods and services (see 21 VAC 5-120-100). Trademark classes are 1 through 34; service mark classes are 35 through 42. The registration fee is $30 per class. (Example: The fee for registering one mark in two classes would be $60). Please use separate applications if requesting registration as both a trademark and service mark. Describe the product or service(s) the mark represents (identifies): Describe the product (trademark) or service(s) provided (service mark) which the mark identifies. (Trademark example: manufacture and production of labeled brunswick stew for public consumption. Service mark example: Service which includes maintenance and repair of automobiles). Date mark was first used: Provide the dates the mark was first used anywhere and first used in Virginia. The mark must be in use, in commerce, in the Commonwealth of Virginia prior to submitting the application. Item 2 Item 3 Item 4 Item 5 Item 6 Item 7 Items 8 and 9 Item 10 Please Note: A specimen of the mark must accompany this application: Provide a specimen of the mark which demonstrates the manner in which the mark is being used. (Example: An appropriate trademark specimen may include an actual label affixed to the product, or a photograph of the product with the mark clearly visible. Service mark specimens may include actual letterhead, stationary, business card, advertisement dated within the past year and the name and date of the publication in which it was published). Item 11 Signature of applicant & notary public The application must be signed before a notary public. Additional assistance can be obtained by calling (804) 371-9051 or at www.scc.virginia.gov/srf. Mailing address: Division of Securities & Retail Franchising, PO Box 1197, Richmond, VA 23218 American LegalNet, Inc. www.FormsWorkFlow.com TM 1 (11/09) COMMONWEALTH OF VIRGINIA STATE CORPORATION COMMISSION DIVISION OF SECURITIES AND RETAIL FRANCHISING 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:_______________________________________
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