Statement Of Trademark Registration Of An Individual Resident Of Colorado printable pdf download

Statement Of Trademark Registration Of An Individual Resident Of Colorado

Form 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 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)

(Mark the applicable box and complete the statement. Caution: Mark only one box.)

The trademark is a standard character trademark and the characters constituting the trademark are

__________________________________________________________________________________.

The trademark is a special form trademark and a description of the attached drawing is

__________________________________________________________________________________.

4. A detailed description of the goods or services in connection with which the trademark is used is

_____________________________________________________________________________________.

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

(Class)

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

_____________________________________________________________________________________.

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

predecessor in interest is __________________________.

(mm/dd/yyyy)

TDMK_IND

Page 1 of 2

Rev. 10/31/2011

Statement Of Trademark Registration Of An Individual Resident Of Colorado

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