Registration Of Trademark Or Service Mark - Pennsylvania Department Of State
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4PENNSYLVANIA DEPARTMENT OF STATE
BUREAU OF CORPORATIONS AND CHARITABLE ORGANIZATIONS
Return document by mail to:
Registration of Trademark or Service Mark
DSCB:54-1112
Name
(rev. 7/2015)
Address
*1112*
City
State
Zip Code
1112
Return document by email to:
________________________________
Read all instructions prior to completing.
Fee: $50
In compliance with the requirements of the 54 Pa.C.S. § 1112 (relating to application for registration), the
undersigned, having adopted and used a trademark or service mark in this Commonwealth and desiring to register such
mark, hereby states that:
1.
The name of the applicant is (see instruction A):
2. The residence, location or place of business of the applicant is (see instruction B):
Number and street
City
State
Zip
County
3. The name and description of the mark is (a facsimile of the mark to be registered accompanies this
application as Exhibit A and is incorporated herein by reference):
4. General class in which such goods or services fall is (use only one of the classifications as set forth in
the general classes of goods and services established by the United States Patent and Trademark Office
and set forth in instruction G):
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Parent category: Business