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To Record Trademark--To Commissioner Of Customs



TO RECORD TRADEMARK--TO COMMISSIONER OF CUSTOMS

U.S. Customs Service Commissioner of Customs Washington, D.C. 20226

Re: Recordation of Trademark To the Commissioner

[Name] hereby makes application to record the following trademark with the Department of the Treasury, Bureau of Customs:

[Describe trademark, giving its registration number and other pertinent data]

As a part of this application, applicant submits the following information:

1. Trademark owner

[include name, complete business address, and citizenship of trademark owner or owners];

2. The goods bearing the recorded trademark are manufactured in [Place of Manufacture]

3. State, as appropriate: There are no foreign persons or business entities authorized or licensed to use the trademark by the trademark owner or [Name of Person or Entity], is located at [Principal Business Address] is the only foreign [Person or Business Entity] authorized to use the trademark. Such [Person or Entity] is authorized to use the trademark for the following purposes:


4. State, as appropriate: There are no parent or subsidiary companies or other foreign companies under common ownership or control of the trademark owner that use the above-described trademark or Company, a subsidiary of [Name of Trademark Owner] uses the above-described trademark abroad for the following purposes:




Enclosed, please find:

(A) A status copy of the Certificate of Registration for the above mark certified by the United States Patent and Trademark Office showing title and the name of [Name of Trademark Owner]

(B) Five copies of the Certificate; and

(C) A check in the amount of $ [Amount of fee] to be applied to the recordation fee for the mark.



Signature Date