SUPPLEMENTAL
REGISTER APPLICATION
REGISTRATION
OF TRADEMARK IN THE UNITED STATES PATENT AND TRADEMARK OFFICE
Mark: __________________________________
Class
Number:
__________________________________
TO
THE COMMISSIONER OF PATENTS AND TRADEMARKS:
(Insert
appropriate identification of applicant)
The
above identified applicant has adopted and is using the trademark shown in the
accompanying drawing for _________________________________ (Common, Usual or
Ordinary Name of Product) and requests that such mark be registered in the
United States Patent and Trademark Office on the Supplemental Register
established by the Act of July 5, 1946.
The
trademark was first used on the goods on _____________ (Date); was first used
in __________________________________________ (Type of Commerce) commerce on
______________ (Date); and is now in use in such commerce.
The
mark is used by applying it to ___________________________________ (Manner of
Application, such as the goods or labels affixed to the
________________________ (Product)).
Five specimens showing the mark as actually used are presented herewith.
(Power
of attorney may be inserted at this point in the application or may be on a
separate sheet. If power of attorney to
be part of application, add:
POWER
OF ATTORNEY
Applicant
hereby appoints ____________________________________ (Names(s)), of
________________________________________________________________ (Address),
_____________________________________ (an Attorney or Attorneys at law or Other
Title, such as: secretary of the
applicant corporation) to prosecute this application to register, to transact
all business in the Patent and Trademark Office in connection therewith, and to
receive the certificate of registration.)
______________________________ _____________________
Signature
Date