Statement Of Trademark Registration Of A Reporting Entity printable pdf download

Statement Of Trademark Registration Of A Reporting Entity

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 a Reporting Entity

filed pursuant to § 7-70-102 of the Colorado Revised Statutes (C.R.S.)

1. For the reporting entity delivering this statement, its ID number, true name, form of entity and the

jurisdiction under the law of which it is formed are

ID Number

_________________________

(Colorado Secretary of State ID number)

True name

______________________________________________________

Form of entity

______________________________________________________

Jurisdiction

______________________________________________________.

(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

__________________________________________________________________________________.

3. 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)

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

_____________________________________________________________________________________.

5. The date of first use in commerce of the trademark in this state by such entity or such entity’s predecessor

in interest is __________________________.

(mm/dd/yyyy)

6. The registrant identified above is currently using the trademark in commerce in this state and such registrant

believes, in good faith, that such registrant has the right to use the trademark in connection with the goods

or services listed above and such registrant’s use of the trademark does not infringe the rights of any other

person in that trademark.

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

This document contains additional information as provided by law.

TDMK_RE

Page 1 of 2

Rev. 10/31/2011

Statement Of Trademark Registration Of A Reporting Entity