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MINNESOTA SECRETARY OF STATE
bottom of the screen to capture your data
APPLICATION FOR RENEWAL OF TRADEMARK,
entry for printing. After printing, sign and
send applicable fees as required.Note:
SERVICE MARK, CERTIFICATION MARK OR COLLECTIVE MARK
Selecting "Reset" will clear all data entry
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The renewal form can only be filed during the 6 months
preceeding the expiration date listed in Item 5 below. The
renewal cannot be accepted before or after this six month
time period.
The filing fee to renew the registration for 10 years is $25.00.
Please read ALL of the instructions on the back of this form
before you fill it out and please remember this form must
be signed.
Mark #:
CURRENT INFORMATION ON FILE:
4. Date of original filing
1. Mark
2. Classification Number
5. Current expiration date
3. Current Markholder(s) and Address(es)
If the address(es) of the current markholder(s) have changed, list all
address change information below: (Note: If the identities of the
Markholder Name
markholder(s) have changed, an assignment must be filed.)
New Addresses:
Street:
_______________________________________________________
City:
_______________________________________________________
Street:
State:
Zip:
_______________________________________________________
City:
Markholder Name
State:
Zip:
Street:
City:
State:
Zip:
I certify that I am authorized to execute this renewal and I further certify that I understand that by signing it I am subject to the penal-
ties of perjury as set forth in Minnesota Statutes section 609.48 as if I had signed this document under oath.
6. Signature _______________________________________________
Date
_____________________
7. Name and telephone number of a contact person ____________________________________ (____)_______________
bus44
Rev. 3-03
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