Form Tm 1 - Application For Registration Of A Trademark Or Service Mark printable pdf download

Instructions for Completion of

Application for Registration of a Trademark or Service Mark

See Form TM1

Item 1

Applicant (owner name and address): The applicant is the individual or entity that owns the mark. The mark

will be used to distinguish the goods or services of the owner from those provided by others. The name of the

applicant (owner) may be determined by the entity type in Item 3. If the applicant is a partnership, both

individuals must be listed as the owner and both must sign the application before a notary public.

Item 2

Contact person name and address: Name and address of person we may contact with any questions we may

have. Please furnish an email address, if available.

Item 3

Applicant is a: Select one of the entity types below that best identifies the type of entity of the applicant. Also

indicate the applicant’s state or jurisdiction of formation:

Corporation

Limited Liability Partnership

Non Public Corporation

Corporation of the Commonwealth

Limited Partnership

Partnership

Federal Agency

Limited Liability Company

Real Estate Investment Trust

Federally Chartererd Savings Bank

Local Government Authority

Sole Proprietorship

General Partnership

Municipal Corporation

State Agency

Individual

National Banking Association

Unincorporated Association

Other

Item 4

Kind of mark: Indicate whether you are requesting registration of the mark as a trademark or service mark. A

trademark is any word, name, symbol, device or combination thereof, used by a manufacturer or merchant to

identify its goods and distinguish them from others. (Example: brand names identifying goods such as Pepsi

Cola for a soft drink). A service mark is any word, name, symbol, device of combination thereof, used by a

manufacturer or merchant to identify its services and distinguish them from others. (Example: identifies services

such as McDonald’s for a restaurant service).

Item 5

Identify trademark or service mark (or attach an exhibit): Indicate what the mark is on this line. If the mark is

comprised of words only, type or write the words here. If the mark also includes a design, symbol or image,

attach an exhibit of the mark to the application. An exhibit is a blank piece of paper with an appearance of the

mark only without extraneous markings.

Item 6

Class number(s) of goods or services: Indicate in which class you wish to register the mark. Classes are

groupings or categories of goods and services (see 21 VAC 5-120-100). Trademark classes are 1 through 34;

service mark classes are 35 through 42. The registration fee is $30 per class. (Example: The fee for registering

one mark in two classes would be $60). Please use separate applications if requesting registration as both a

trademark and service mark.

Item 7

Describe the product or service(s) the mark represents (identifies): Describe the product (trademark) or

service(s) provided (service mark) which the mark identifies. (Trademark example: manufacture and

production of labeled brunswick stew for public consumption. Service mark example: Service which includes

maintenance and repair of automobiles).

Items 8

Date mark was first used: Provide the dates the mark was first used anywhere and first used in Virginia. The

and 9

mark must be in use, in commerce, in the Commonwealth of Virginia prior to submitting the application.

Item 10 Please Note: A specimen of the mark must accompany this application: Provide a specimen of the mark

which demonstrates the manner in which the mark is being used. (Example: An appropriate trademark

specimen may include an actual label affixed to the product, or a photograph of the product with the mark

clearly visible. Service mark specimens may include actual letterhead, stationary, business card, advertisement

dated within the past year and the name and date of the publication in which it was published).

Item 11

Signature of applicant & notary public – The application must be signed before a notary public.

Additional assistance can be obtained by calling (804) 371-9051 or at

Mailing address: Division of Securities & Retail Franchising, PO Box 1197, Richmond, VA 23218

Form Tm 1 - Application For Registration Of A Trademark Or Service Mark

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