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Publication Of Mark Registered Under Prior Act-Affidavit



PUBLICATION OF MARK REGISTERED UNDER PRIOR ACT-AFFIDAVIT

Mark [Mark]

Registration Number [Registration Number]

Date of issue [Date of issue]

To: [name of original registrant]

TO THE COMMISSIONER OF PATENTS AND TRADEMARKS:

State of [State of notary public]
County of [County of notary public]

[Name of registrant or person authorized to sign for registrant], being duly sworn, states that:

1. [Name of registrant] owns the above identified registration, as shown by records in the Patent and Trademark Office;

2. Such registration is now in force;

3. The mark shown therein is in use in [Type of commerce] commerce on each of the following goods stated in the registration: [List the goods or insert the words all the goods]; and

4. The benefits of the Act of July 5, 1946, are hereby claimed for such registration.



Signature Date