Statement Of Renewal Of Trademark Registration Filed Prior To May 29, 2007 Of A Non-Reporting Entity Page 2
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1
2
3
4Mailing 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)
(If applicable, adopt the following statement by marking the box.)
The mailing address in the records of the Secretary of State is no longer different than the street
address and is no longer required.
6.
(Mark the applicable box and complete the statement. Caution: Mark only one box.)
Such registrant 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 registrant 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.)
Street address
______________________________________________________
(Street number and name)
______________________________________________________
__________________________
CO
____________________
(City)
(State)
(Zip Code)
Mailing address
______________________________________________________
(leave blank if same as street address)
(Street number and name or Post Office Box information)
______________________________________________________
__________________________
CO
____________________.
(City)
(State)
(Zip Code)
The person appointed as registered agent has consented to being so appointed.
7. The goods or services in connection with which the trademark was used on the date of first use in
commerce in this state are described in detail as follows
_____________________________________________________________________________________.
TDMK_REN_NRE_LEG
Page 2 of 4
Rev. 1/01/2008
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