Application For Registration Of Trademark/service Mark Form - Arizona Secretary Of State
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1
2Office Use_____________
Approved by:_____________
Please mail registration to:
Betsey Bayless
Secretary of State
Business Services - Marks
th
1700 West Washington 7
Floor
Phoenix, Arizona 85007
602/542-6187
Filling Fee $15.00
Page 1 of 2
APPLICATION FOR REGISTRATION OF TRADEMARK/SERVICE MARK
A.R.S. §44-1441 THROUGH 44-1455
This is a registration for an Arizona Trademark/Service Mark only in accordance with
.R.S. §44-
A
1441 through 44-1455. This certificate does not in any way constitute the registration of an Internet
Domain Name.
Please clearly print or type to avoid errors in registration. Your certificate and future renewal
notices are dependent on accurate address information including suite numbers. Remember to
update your records if you move.
1.
Provide accurate word description of your mark (For logo or symbol):
2.
Name of applicant:
Business Address:
Street
City
State
Zip
Phone (Optional):
3.
Please check one: Do not select “Corporation” if not currently registered, or your
application will be returned to you.
Individual
Association
Firm
Union
Partnership
Corporation State of Incorporation
Other Organization
Please describe:
4.
Description of goods on which this mark is used:
5.
Please attach three samples of your mark with this application on 8 1/2 by 11 inch paper.
One sample should be camera ready.
6.
Classification Number (Refer to the Trade Name & Trademark pamphlet.):
7.
Date Mark was first used:
8.
Date Mark was first used in this State:
Please see page 2.
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