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Application For Trademark Registration-Individual
APPLICATION FOR TRADEMARK REGISTRATION-INDIVIDUAL
United States Patent and Trademark Office
Washington, D.C. 20231
Trademark
Class
TO THE COMMISSIONER OF PATENTS AND TRADEMARKS:
Applicant: [Name of applicant]
Address: [Address of applicant]
Citizenship: [Citizenship of applicant]
The above applicant has adopted and is using the trademark shown in the accompanying drawing for the following goods:[list of goods]
and requests that said mark be registered in the United States Patent and Trademark Office on the Principle Register.
The trademark was first used on the goods of the Date of [date trademark first used] , was first used in Interstate commerce on the date of [date trademark first used in insterstate commerce], and is currently in use in interstate commerce.
THE MARK IS USED OR APPLIED IN THE FOLLOWING MANNER:
Five (5) specimens showing the mark as actually used are included with this application.
[Name of Applicant] being hereby warned that willful false statements and the like so made are punishable by fine or imprisonment, or both, under Section 1001 of title 18 U.S. Code, and that such willful false statements may jeopardize the validity of the application or any registration resulting therefrom declares: that he/she believes himself/herself to be the owner of the trademark sought to be registered; and to the best of his/her knowledge and belief no other person, firm, corporation, or association has the right to use said mark in commerce either in the identical form or in such near resemblance thereto as to be likely, when applied to the goods of such other person, to cause confusion, or to cause mistake, or to deceive; that the facts set forth in this application are true, and that all statements made of his/her own knowledge are true and all statements made on information and belief are believed to be true.
[Signature of Applicant]