Form F0023 - Application To Register Or Renew Trade And Service Marks 2008

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OFFICE OF THE MISSISSIPPI SECRETARY OF STATE
11 F0023—Page 1 of 4
P. O. BOX 136, JACKSON, MS 39205-0136
601-359-1633
Application to Register or Renew Trade and Service Marks
Please refer to on-line instructions while completing this form.
1. Please indicate below the type of registration desired (See instructions for definitions)
Trademark
Original
Mississippi Registration Number
Service Mark
Renewal
For Renewals Only
Name of owner (person, corporation or other entity) applying for registration
2.
Business address of applicant
Telephone (area code first)
3.
Mailing Address
City
State
ZIP Code
Business Email Address:_____________________________________________________________________________
Applicant is a(n)
4.
Corporation
Individual
Partnership
Limited Partnership
Limited Liability Company
Limited Liability Partnership
Other
For Foreign Corporation, Partnership, Limited
State or country of
Liability Company, Limited Liability Partnership or
owner
Other
5. If partnership or other entity, list names and business addresses of general partners, owners and/or
managers:
Name and
Title
address
Name and
Title
address
Name and
Title
address
F0023 (Rev. 9/2008)

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