TMSM-02
Rev. 10/02
New Jersey Division of Revenue
APPLICATION TO RENEW A REGISTERED TRADE OR SERVICE MARK
This form may be used by applicants seeking to renew a registered State trade or service mark pursuant to
NJSA 56. Applicants are responsible for strict adherence to all requirements as set forth in State law.
Applications may be submitted anytime within six months prior to the expiration of the registration period.
1. Trade/Service Mark Number: (as assigned by the Treasurer and listed on the Certificate of Registration)
2. Classification Within Which the Goods or Services Fall: (as listed on the Certificate of Registration or Filed
Registration Application Form)
3. Owner Information:
a. Name: (must match the name shown on the Division of Revenue's records)
b. Current Business Address:
4. Assignee Information: (if applicable, provide assignee name/address)
a. Name:
b. Address:
5. Signature(s) and Statement of Continued Use: (verification required)
The owner attests that he or she is the owner of the mark, and that the mark is still in use in this State.
__________________________________________
___________________
(Signature of Owner, or a Member of the Firm, or an
(Date)
Officer of the Corporation or Business Applying)
__________________________________________
___________________
(Assignee, if Applicable)
(Date)
Subscribed and sworn to before me, ____________________________________,
a Notary Public, this ______ day of ___________ A.D. 20 ____.
________________________________________
(Notary Public)
Note: Attach a specimen showing the mark as actually used on or connection with the goods or services involved.