Statement Of Renewal Of Trademark Registration Filed Prior To May 29, 2007 Of A Non-Reporting Entity (Page 3 of 4) in pdf

The class into which such goods or services fall is ____________________________________________.

(Class)

(Caution: Leave blank unless deleting goods or services.)

The goods or services with respect to which the trademark is no longer used are

_____________________________________________________________________________________.

8. A description of the attached specimen sufficient to identify the nature of the specimen is

_____________________________________________________________________________________.

9. The date of first use in commerce of the trademark in this state by such registrant or such registrant’s

predecessor in interest is __________________________.

(mm/dd/yyyy)

10. Such registrant is currently using the trademark in commerce in this state in connection with the goods or

services described in the statement of trademark registration, excluding any goods or services identified

above.

11. Such registrant believes, in good faith, that such registrant has the right to use the trademark in commerce

in this state in connection with the goods or services, excluding any goods or services identified above,

and such registrant’s use of the trademark does not infringe the rights of any other person in that

trademark.

12.

(If applicable, adopt the following statement by marking the box and include an attachment.)

This document contains additional information as provided by law.

Notice:

Causing this document to be delivered to the Secretary of State for filing shall constitute the affirmation or

acknowledgment of each individual causing such delivery, under penalties of perjury, that such document is

such individual's act and deed, or that such individual in good faith believes such document is the act and deed

of the person on whose behalf such individual is causing such document to be delivered for filing, taken in

conformity with the requirements of part 3 of article 90 of title 7, C.R.S. and, if applicable, the constituent

documents and the organic statutes, and that such individual in good faith believes the facts stated in such

document are true and such document complies with the requirements of that Part, the constituent documents,

and the organic statutes.

This perjury notice applies to each individual who causes this document to be delivered to the Secretary of

State, whether or not such individual is identified in this document as one who has caused it to be delivered.

13. The true name and mailing address of the individual causing this document to be delivered for filing are

____________________ ______________ ______________ _____

(Last)

(First)

(Middle)

(Suffix)

______________________________________________________

(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 and include an attachment.)

This document contains the true name and mailing address of one or more additional individuals

causing the document to be delivered for filing.

TDMK_REN_NRE_LEG

Page 3 of 4

Rev. 1/01/2008

Statement Of Renewal Of Trademark Registration Filed Prior To May 29, 2007 Of A Non-Reporting Entity Page 3

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