Trademark And/or Service Mark Renewal Form Page 4
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5State of Delaware
Application for Renewal of Registration of
Trademark or Service Mark
1.
Name of applicant:
2.
Business Address:
3.
If a business entity, list State of Formation:
4.
TRADEMARK or SERVICE MARK:(Specify filing type*)
(a)
Please describe mark in detail:
(b)
Registered with the Secretary of State of the State of Delaware on:
(c)
Class in which such goods or services fall: No.
Name of class:
5.
The above said Mark is still in use in the State of Delaware.
___________________________
Signature of Applicant
Official Capacity
*PLEASE SEND A SPECIMEN OR FACSIMILE OF MARK IN DUPLICATE
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