Trademark Service Mark Application (General Laws Chapter 110h, Section 3) - Commonwealth Of Massachusetts

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Filing Fee $50.00 per class
5 year registration period
The Commonwealth of Massachusetts
SM
William Francis Galvin
Secretary of the Commonwealth
One Ashburton Place, Boston, Massachusetts 02108-1512
Trademark / Service Mark Application
FORM MUST BE TYPED
FORM MUST BE TYPED
(General Laws Chapter 110H, Section 3)
All information must be completed or this document will not be accepted for filing.
(1) Applicant’s name and business address:
a) Individual: ______________________________________________________________________________________
Last
First
Middle
Business address: _________________________________________________________________________________
Number
Street
_________________________________________________________________________________
City
State
Zip
or
b) Business Organization: _____________________________________________________________________________
Business address: _________________________________________________________________________________
Number
Street
_________________________________________________________________________________
City
State
Zip
(2) If applicant is a business, identify type (check box), and if applicable, state and date of organization:
corporation
limited liability company
limited partnership
partnership
sole proprietor
other _________________________________________________________________________________________
(indicate entity type)
a) State of incorporation or organization: ____________
b) Date of incorporation or organization: _____________
(3) If applicant is a partnership, state the names of the general partners:
c110hs3 10/26/06

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