Application For Registration Trademark Or Service Mark

Secretary of State OFFICE OF SECRE T A R Y OF STATE CORPO R A TI O NS DIVISION 2 Martin Luther King Jr. Dr. SE Suite 313 West Tower Atlanta, Georgia 30334 (404) 656 - 2817 http://sos.ga.gov/ APPLICATIO N FO R REGISTRATION TRADEMA R K O R SERVIC E MARK NOTICE TO A PPLIC A N T: SEE GENERAL INSTRUCTIONS FOR COMPLETING THIS APPLICATION. In compliance w i th O.C . G.A. 247 24710 - 1 - 440 et seq., t he u ndersigned, having adopted a nd used a t ra d em a rk or s ervice m a rk in this S tate a nd d esiring to file the same for public record in the Office of t he Secret ar y of State o f Ge o rgia, does h e re b y ce r tify , under penalty of perjury, th e follo w ing: 1. Name of Applicant 2. Principal Business Address Ci t y S t ate Zip Code Mailing Address (if different from principal business address) Ci t y S t ate Zip Code 3. If applicant is a n entity, please indicate the state of incorporati o n/formation/organization: 4. Describe the mark. The description you provide is the way the mark will be registered. (Attach additional sheet if necessary) 5. Disclaimer (if applicable): No claim is made to the exclusive right to use : apart from the mark as shown. 6 . ( a ) If a t radem ar k, w hat goods a r e offered o r sold under the m ar k ? OR ( b ) If a serv i c e mark, what s e rvices are provided under t he ma rk ? 7 . Class No: (A separate a pplication must be filed for each cl a ss in w hich a r egistration of the m ar k is sought.) 8 . Date of first use of the mark b y a pplicant, predecessor, or licensee. (Give m onth, d a y and y e a r . ) ( a ) A n ywh e re: ( b ) In Geo r gia: 9 . Mode or m anner in which the mark is used in connection with identified (a) goods or (b) services. Check all that apply in either (a) or (b) : (a) Trademark: To tags/labels affixed to goods To tags/labels affixed to containers of goods Directly to containers of goods Directly to goods Other: (b) Service Mark : Advertising brochures Advertising leaflets/flyers Newspaper advertisements Signs Business cards Menus Other: 10. The applicant is the o w ner of the mark described herein , the m ark i s in use, the specimens filed herewith are true and correct , and, to th e best of his/her kno w ledg e , no o t her person exc e pt the appl i cant has the right to us e such mark in this S tate either in its i dentical form or in such near r e semblance as to be likely , when applied to the goods or services of such other person, t o cause confusion or mistake, or t o deceive . Signature of App l icant: Print Name: Official Title (if signing for an entity) : Email: Secondary Email: Mail or d e li v er to the Secreta r y of Sta t e, at the above a dd r e s s, the foll o w i n g : 1) This completed application. 2) Three (3) specimens of the mark as currently used. May be 3 samples of the same specimen . (See General Instructions) 3 ) A drawing page showing only the mark on an 8 275 x 11 white sheet of paper. 4 ) A filing fee of $15.00 payable to the Secretary of State. Filing fees are non - refundable and non - transferable . FORM TMAPPL (Rev . 6/2019 ) American LegalNet, Inc. www.FormsWorkFlow.com TMAPPL GENERAL INSTRUCTIONS (Rev. 8 /2018) GENERAL INSTRUCTIONS Fee : The filing fee is $15.00 per application . Make checks or money orders payable to the Secretary of State. Filing fees are non - refundable. Specimens : T hree (3) specimens showing cur rent use of the mark in commerce must be submitted with the application . Three samples of the same specimen are acceptable. If a trademark, the specimen should be the actual tags or labels affixed to goods, actual tags or labe ls affixed to containers of the goods, or packaging used on the goods . If a service mark, the specimen should be in the form of an advertisement (e.g. newspaper ad, leaflet, brochure, flyer, etc. ) and must denot e the service rendered to the public. If specimens are bulky or of value, ( i.e. jewelry, t - shirts, caps, etc. ) , please submit photographs of the actual specimens. The photo graph s should clearly and legibly depict the mark along with all material pertinent t o the registration. S pecimens will not be returned to applicant. Drawing Page : A drawing of the mark on an 8 275 x 11 white sheet of paper should accompany the application . A drawing is a clear and accurate visual depiction of the mark. If the mark contains only words, list only those words on the drawing page. A drawing should not show additional words or designs that are not part of the mark. In Use : P rior to registration of t he mark , the mark must be in use in Georgia on or in connection with the goods/services identified in the application . Goods must already be offered for sale or in distribution in Georgia in order to register a trademark. Services must already be sold or otherwise rendered in this State in order to register a service mark. The mere advertising of future goods or services does not constitute use of a trademark or service mark in Georgia. Application Form : Type or print in blue or black ink. C omplete all applicable items. Items #3 and #5 may not appl y to all applications . A ttach additional sheet(s) if needed . All previous revisions of this application form are obsolete. Item 1 : Enter the name of the applicant . Applicant is the owner of the mark; the applicant is not necessarily the person filing the application . The applicant may be an individual or an entity (e.g. corporation, limited liability company (LLC), limited partnership ) . Item 2 : Enter the principal business address of the applicant. If mailing address is different , enter the mailing address in the space provided . Item 3 : If applicant is a n entity (e.g. corporation, LLC , limited partnership) , indicate the state of incorporation, format ion, or organization of the entity . Item 4 : Enter a concise description of the mark. List only one mark per application . If the mark consists of word ( s ) only, list only the words. If the mark is a design only, then provide a detailed written description of the design. If the mark is word ( s ) and a design, then provide a detailed written description of the word ( s ) and design . The description must be consistent with how the mark appears on the specimens . Do not att ach a copy of the mark and Do not draw the mark on the application. Do not write in Item 4 of the application what the mark may mean, stand for, or represent. If the mark contains non - English words, please provide an English translation. Attach additional sheets if necessary. Item 5: If applicable, e nter a disclaimer for word(s) or design(s) which are merely descriptive of the goods or services , , ), or designate entity status (e , ). A disclaimer does not remove the disclaimed matter from the mark. It is simply a statement that the applicant does not claim exclusive rights in the disclaimed wording or design apart from the mark . Item 6 : If a trademark, state the specific goods sold or distributed with the mark affixed ; or, if a service mark, state the specific services rendered. List only those goods/services currently available. Do not include future goods/services. All goods/services listed in Item 6 m ust fall within the class designated in Item 7. Item 7 : Enter class number. Number must correspond with the identified goods/services. List only one class number per application . If a mark is used in more than one class, it may be registered in more than one class. A separate application must be filed for registration in each eligible cl ass. See below for list of classes. Item 8 : Enter the date of first use of the mark "anywher e" and the date of fi rst use of the mark "in Georgia " (month/day/year). If the mark has only been used in Georgia, the date of first use would be the same for both "anywhere" and "in Georgia . " If only a year or month/year is entered, the date presumed for purposes of registration will be the last day of the year or last day of the month entered. The mark must already be in use in Georgia prior to registration. Item 9 : Enter the mode or manner in which the mark is used i n connection with the identified (a) goods or (b) services. If a trademark, how is the mark applied to the goods?