Statement Of Trademark Registration Of An Individual Not A Resident Of Colorado
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1
2
3Form must be filed electronically.
Paper forms are not accepted.
This copy is a sample and cannot be submitted for filing.
Statement of Trademark Registration of an Individual Not a Resident of Colorado
filed pursuant to § 7-70-102 of the Colorado Revised Statutes (C.R.S.)
1. The true name of the individual registering the trademark is
______________________ ________________ ______________ _______.
(Last)
(First)
(Middle)
(Suffix)
2. The principal address of such individual and, if different, the mailing address of such individual are
Principal (street) address
______________________________________________________
(Street number and name)
______________________________________________________
__________________________ ____ ____________________
(City)
(State)
(Zip/Postal Code)
_______________________ ______________
(Province – if applicable)
(Country)
Mailing address
______________________________________________________
(leave blank if same as street address)
(Street number and name or Post Office Box information)
______________________________________________________
__________________________ ____ ____________________
(City)
(State)
(Zip/Postal Code)
_______________________ ______________.
(Province – if applicable)
(Country)
3.
(Mark the applicable box and complete the statement. Caution: Mark only one box.)
Such individual does not maintain a registered agent in this state and the mailing address to which
service of process in any proceeding based on a cause of action with respect to the statement of
trademark registration may be mailed pursuant to section 7-70-108, C.R.S. is
______________________________________________________
(Street number and name or Post Office Box information)
______________________________________________________
__________________________
___
____________________
(City)
(State)
(Zip/Postal Code)
_______________________ ______________.
(Province – if applicable)
(Country)
OR
Such individual maintains a registered agent in this state and such registered agent’s name and address
are
Name
(if an individual)
____________________ ______________ ______________ _____
(Last)
(First)
(Middle)
(Suffix)
OR
(if an entity)
______________________________________________________
(Caution: Do not provide both an individual and an entity name.)
TDMK_NOTCO
Page 1 of 3
Rev. 10/31/2011
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