Trademark Information Sheet
Individual or Company Information
Owner - Firm or Personal Name:
Entity Type (type of business structure):
State of legal formation:
Street Address:
Phone Number:
Fax Number:
Email Address:
Mark Information
Text of trademark or servicemark:
Does the text have any stylized/design format?
If yes, please provide a sample.
Any logo or symbol?
If yes, please provide a sample.
Has the mark been used?
If yes, first date of use:
If yes, please provide a sample as it is used to sell or market products.
Description of goods or services:
