Mark Registration Form

BARBARA K. CEGAVSKE Secretary of State Website: www.nvsos.gov Mark Registration Form(PURSUANT TO NRS 600) Page 1 Important: Read attached instructions before completing form. USE BLACK INK ONLY - DO NOT HIGHLIGHT ABOVE SPACE IS FOR OFFICE USE ONLY 1.Please DesignateOne Mark PerApplication:2.Mark to beRegistered:(name of mark or words to be included in the mark) 3.Design:4.ClassificationNumber:(see instructions; one class per application) TRADEMARK TRADE NAME SERVICE MARK NO YES Does the mark include a design? (If yes, attach drawing or facsimile) 5.Applicant: (please designate) INDIVIDUAL ENTITY STATE OF INCORPORATION: (If entity) Date the mark was first used by applicant in Nevada (display as mm/dd/yyyy): (See NRS 600.320) 6.Name of Applicant:(from question five) 8.Original Mark Date7.Business Address:In Nevada:Street Number/Post Office Box City State Zip Code This form must be accompanied by appropriate fees. Nevada Secretary of State Mark Registration Pg1Revised: American LegalNet, Inc. www.FormsWorkFlow.com Mark Registration Form(PURSUANT TO NRS 600) Page 2 Important: Read attached instructions before completing form. USE BLACK INK ONLY - DO NOT HIGHLIGHT ABOVE SPACE IS FOR OFFICE USE ONLY 9.Original Mark Date: 10.Use of Mark or Name: (complete only if 11.NotarizedDate the mark was first used by applicant anywhere (display as mm/dd/yyyy): State the specific goods or services for which the mark will be used: 10a. Trademark: 10c. Trade Name: 10b. Service Mark: State how trade name is used (ie. business card, letterhead, signage, etc.): OR OR Check how trademark is used. By applying it: directly to the containers for the goods, to tags or labels affixed to the goods, to tags or labels affixed to the containers for the goods. By displaying it: in advertising. Check how service mark is used. By displaying it: on documents, wrappers, or articles delivered in connection with the service rendered, in other fashion; if so, please Signature of Applicant:The applicant herein states that he has read the above application and that the statement and facts set out therein are true that the mark is currently in use by the applicant; that to the best of his knowledge and belief the applicant is the owner of the mark sought to be registered and no other person has the right in the State of Nevada to use such mark either in the identical form set forth in the application or in such near resemblance to it as might, when applied to the goods or services of such other person, cause confusion or cause mistake or be calculated to deceive. State of County of This instrument was acknowledged before me on Date Signature of Applicant by Notary Signature Notary Stamp . , Printed Name of Applicant Signing trademark) (complete only if (complete only if service mark) trade name) Xdirectly to the goods, in physical association with the goods in the sale or distribution thereof, in advertisements of the service, specify: This form must be accompanied by appropriate fees. Nevada Secretary of State Mark Registration Pg2 BARBARA K. CEGAVSKE Secretary of State Website: www.nvsos.gov American LegalNet, Inc. www.FormsWorkFlow.com BARBARA K. CEGAVSKE Secretary of StateWebsite: www.nvsos.gov Instructions for Mark Registration(PURSUANT TO NRS CHAPTER 600) IMPORTANT: READ ALL INSTRUCTIONS CAREFULLY BEFORE COMPLETING FORM. To ensure the best possible service and to help avoid delays or returns, please be sure you have included: 1.The mandatory $100.00 filing fee.2.The Mark Registration form.3.A specimen (sample of use of the Mark, i.e. advertisement, letterhead, etc.). The specimen must be in blackand white. No colored specimens please.4.The classification of goods or services from the following categories (see item four on the application). Mustbe specific.5.A separate application for each class for which the Name or Mark is used.CLASS NUMBERS OF GOODS FOR TRADEMARKS ONLY Raw or partly prepared materials; (2) receptacles; (3) baggage, animal equipments, portfolios, and pocketbooks; (4) abrasives and polishing materials; (5) adhesives; (6) chemicals and chemical compositions; (7) cordage; (8) smokers222 articles, not including tobacco products; (9) explosives, firearms, equipments, and projectiles; (10) fertilizers; (11) inks and inking materials; (12) construction materials; (13) hardware and plumbing and steam-fitting supplies; (14) metals and metal castings and forgings; (15) oils and greases; (16) paints and painters222 materials; (17) tobacco products; (18) medicines and pharmaceutical preparations; (19) vehicles; (20) linoleum and oiled cloth; (21) electrical apparatus, machines, and supplies; (22) games, toys and sporting goods; (23) cutlery, machinery, and tools and parts thereof; (24) laundry appliance and machines; (25) locks and safes; (26) measuring and scientific appliances; (27) horological instruments; (28) jewelry and precious-metal ware; (29) brooms, brushes, and dusters; (30) crockery, earthenware, and porcelain; (31) filters and refrigerators; (32) furniture and upholstery; (33) glassware; (34) heating, lighting, and ventilating apparatus; (35) belting, hose, machinery packing and non-metallic tiers; (36) musical instruments and supplies; (37) paper and stationery; (38) prints and publications; (39) clothing; (40) fancy goods, furnishings, and notions; (41) canes, parasols and umbrellas; (42) knitted, netted and textile fabrics, and substitutes therefor; (43) thread and yarn; (44) dental, medical, and surgical appliances; (45) soft drinks and carbonated waters; (46) foods and ingredients of foods; (47) wines; (48) malt beverages and liquors; (49) distilled alcoholic liquors, (50) merchandise not otherwise classified; (51) cosmetics and toilet preparations; (52) detergents and soaps. CLASS NUMBERS FOR SERVICE MARKS AND TRADE NAMES ONLY (100)Miscellaneous; (101) advertising and business; (102) financial and insurance; (103) construction and repair; (104)communications; (105) transportation and storage; (106) material treatment; (107) education and entertainment.Your trademark, trade name or service mark will be in effect for 5 years from the date it is filed. It can be renewed for additional 5 year periods simply by filing an application with the Secretary of State within six (6) months preceding the expiration date. The renewal fee is $50.00. Please be sure to notify us in writing if you have a change of address. Trademark laws are totally unrelated to Nevada222s corporation law. If you are interested in filing a corporation or reserving a corporate name, our office will be happy to provide you with the necessary information. Nevada Secretary of State Mark Registration Instructions American LegalNet, Inc. www.FormsWorkFlow.com