Trademark Application: Intake Form Please submit the following information via this online form, which is encrypted with SSL to help ensure the data you enter is secure. Name* Prefix Mr.Ms.Other First Middle Last Suffix Email* Enter Email Confirm Email Phone*Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Trademark Requested*Federal onlyFederal and KentuckyOwnership of Mark*Will you be applying for and do you own the mark as an individual or as a business entity? IndividualBusiness EntityName of Business Entity*DBA ("Assumed Name") of Business EntityCountry of Business Entity*AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabweState of Incorporation/Organization*AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificBusiness Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Business Phone*Business Email* Business Website Confirm Ownership of the Mark*The owner of the mark is the person or entity who controls the nature and quality of the goods identified by the mark and/or the services rendered in connection with the mark.I am/my business entity is the owner of the mark.I am/my business entity is not the owner of the mark.Confirm Right to Use Mark*Do you know of any other individual or business who has registered or has the right to use the mark in an identical or nearly identical form on similar goods and/or services?I know of no other individual/business entity with the right to use the mark.I know of another individual/business entity with the right to use the mark.Type of Mark*A word mark uses ONLY standard characters, which include words, letters, numbers, common punctuation marks, or any combination thereof. So text alone without styling. Word marks may not include color. Common word marks are company names, slogans, and phrases. A design mark includes any special or stylized characters, color, or picture. Common design marks are company logos and graphical images. If the mark includes ANY design element (e.g., styling), it is a design mark.Word MarkDesign MarkWord Mark*Type the mark exactly as it exists (including capitalization and punctuation). Please note that though you must specify the exact wording of your mark, you gain broader rights beyond this exact wording. Trademark registration affords the owner rights to the exact spelling and punctuation used and anything that would be considered "confusingly similar", e.g. a slight variation.Design Mark*Attach a drawing/depiction of the mark. The drawing/depiction should represent all features of the mark for which ownership is claimed. The drawing should be only of the mark itself and should not include the “TM” or “SM” symbol. If you wish to claim rights to the colors used in the mark, the drawing MUST be in color. The drawing should be attached as a clear, high-quality image file, preferably in the .jpg or .pdf format.Accepted file types: pdf, jpg, jpeg, bmp, gif, png, psp.Covered Goods and/or Services*Describe the types of goods and/or services which are identified or promoted by the mark. A mark must be registered in one or more of the 45 "classes" (categories) designated by the USPTO. To secure the broadest rights possible, include all goods and/or services covered by the mark. However, keep in mind that while you secure more rights to use the mark if you register in multiple classes, the application fee (typically $225) must be paid per class.Current Status of Mark*Currently using the trademark in commercePre-registering the trademark before using it in commerceDate of First Use of the Mark*Date the mark was first used in trade/commerce in any state or country. Indicate your best estimate as to the earliest date the mark was first used by you, your licensee, your business entity, or your business entity’s related company/predecessor-in-interest. Date Format: MM slash DD slash YYYY Date of First Use of the Mark in Commerce*Date the mark was first used in interstate (between states) or international trade/commerce. Indicate your best estimate as to the earliest date the mark was first on goods sold across state lines or used in advertisements for services offered to those from another state, such as by appearing on the business’ website. Date Format: MM slash DD slash YYYY Specimen*Attach a specimen showing actual use of the mark in the normal course of trade/commerce. A specimen is a real-world example of the mark being used in the context of selling goods or advertising services. The specimen must demonstrate actual use of the mark claimed in the previous question. The specimen should be attached as an image file, preferably in .jpg or .pdf format. Acceptable specimens for goods include labels, tags, containers, or sales displays. A specimen for goods should be a photo which shows the mark stamped on, printed on, or otherwise applied to the goods or their packaging. Acceptable specimens for services include signs, brochures, leaflets, flyers, or advertisements (including websites and online ads). Business cards, stationery, letterhead, and invoices are also appropriate specimens if they show a connection between the mark and the type of services being offered. A specimen for services should be a photo or screen capture showing the mark as used in the sale or advertising for the services, or the entire brochure/flyer/etc. itself.Accepted file types: pdf, jpg, jpeg, bmp, gif, png, psp.Intent to Use Trademark*Do you have a bona fide intention to use the mark in commerce or in connection with all the goods and/or services identified? A trademark pre-registration (an "Intent to Use" registration) is meant only for those who truly intend to use the mark as a trademark for the listed goods and/or services in the near future. The lack of this intention could jeopardize the validity of the registration and result in its cancellation.YesNoAdditional InformationPlease include any additional information you would like our attorneys to know.Disclaimer*Our attorneys may review the information you submit for the purposes described on this website. The use of this form for communication with our firm does not establish an attorney-client relationship. Our review of the information sent to us will not preclude us from representing any other client if confidential information is sent through this form.I agreeI do not agreeNameThis field is for validation purposes and should be left unchanged.
