Trademark Or Service Mark Renewal Application
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Illinois
Registration #:
TM/SM-30
Trademark or Service Mark
This space for use by Secretary of State.
Secretary of State
Renewal Application
Department of Business Services
Trademark Division
501 S. Second St., Rm. 330
Springfield, IL 62756
Type, Laser Print or Legibly Print in Black Ink.
217-524-0400
Do not staple, glue or tape
examples to the application
Renewal Fee: $5
See additional page for instructions
and required documentation.
Items 1-4 refer to Registrant
1. Name of Registrant: ______________________________________________________________________________
2. Registrant is a (check one):
❐ Corporation
❐ Union
❐ General Partnership
❐ Limited Liability Partnership (LLP)
❐ Individual
❐ Association
❐ Limited Partnership (LP) ❐ Limited Liability Company (LLC)
❐ Other (specify): _______________________________________________________________________________
3. a) If a Corporation, LP, LLP or LLC, indictate the State in which it is organized: _______________________________
b) If an LP or LLP, Name of one of the General Partners: _________________________________________________
4. Business Address:
Mailing Address:
Street:
Street:
City:
State:
ZIP:
City:
State:
ZIP:
— — — - — — —
5. Registration Number:
Original Date of Registration: ______________________________
MM/DD/YYYY
6. Name of Mark: __________________________________________________________________________________
7. List the specific goods or services named on the original application: ________________________________________
______________________________________________________________________________________________
The applicant hereby appoints the Illinois Secretary of State as agent for service of process in an action relating only to the renewal registration,
which may be issued pursuant to this application if the renewal registrant is, or shall become, a non-resident individual, or foreign partnership,
limited liability company, association or corporation not licensed to do business in the State, or cannot be found in this State.
Printed by authority of the State of Illinois. July 2015 — 5M — C 247.15
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