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: