Form PTO Form 1479 PTO Form 1479 Trademark/Service Mark Form, Supplemental Register

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Navigation History: Insbuction > Applicant > Mark> Goods/Services/Rling Basis > Attorney/Dom. Rep.fCorrespondence

> Fee/Signature

Under the Paperwork Reduction Act of 1995 no persons are required to resJX)Od to a collection of information unless it diSl)Eys a valid 0MB control number.
PTO Form 1479 (Rev 09/2006)
Approved for use through xx/xx/xxxx OMB Control No. 0651-0009

Trademark/Service Mark Fo1·m, Supplemental Register
Version 7.1
\Vatch the "Before \'OU file" T�fiN video for an O\'erview of tbe most important issues to be aware of when filing a trademark application with the USPTO.

To file the application electronically, please complete the follo\\ing steps:
I. Answer the first question below to create an application fonn showing only sections rele,;ant to your specific filing.
2. For help at any point. click on any underlined word on any page.
3. After answering the first wizard question. click on the CONTINUE button at bottom of the page.
4 . Once in the actual form. complete all fields with a * symbol. since they arc mandatory fields for TEAS filing purposes.
5. Validate the form, using the "Validatc R button at the end of the form. If there arc errors, return to the fonn to make the correction. A "WamingR may be corrected or by-passed.
6. Double-check all entries through the links displayed on the Validation page.
7. You may sa\·e your work for submission at a later time by clicking on the SaYe Form button at the bottom of the Validation page.
8. \Vhcn ready to file. use the Pay/Submit button at the bottom of the Validation page. This will allow you to choose from three (3) different payment methods: credit card, automated deposit account. or electronic funds transfer.
9. After accessing the proper screen for payment, and making the appropriate entries. you will receive a confirmation screen if your transmission is successful. This screen will say SUCCESS! and will provide your assigned serial
number.
10. An email acknowledging receipt of the submission (a filing receipt) will be sent to the correspondence email address of record.
Once you submit this application, the USPTO will not cancel the filin& or ufund your fee. The fee is a processin& fee, which we do not refund e\'en ifwe cannot issue a re&istration after our substanti\'e re\'iew.

Imponant: After 1his application is submilted. the USPT0 will send a filing receipt to the email address of either (A) 1he appointed attomcy. if any, otherwise (B) 1he trademark applicant owncr'holder.
Contact Polars:
• General trademark laformarioa: Please reYiew the infonnation posted at Where Do I Start. If you ha\"e remaining questions. email TradcmarkAssistanceCcnter@'usp1o.gov. or telephone l-800-786-919 9\. .
• Help: For instructions on how to use the electronic fonns. or help in rcsoh·ing technical glitches. please email TEAS@uspto.gov. Please include your telephone number in your email. so we can talk to you directly. if necessary. Also.
include the rele\·ant serial number or registration number. if existing.
NOTE: 1e T£AS 51 port Te.om foe s or probl<" s re l.ited to the proceu of mplelmq t� ' ctrc IC for not m w��t mfor tJon would� corrffl for entry w,tt n if< rm, or Jlher ro.id tr.id1 r1c I
PIE se rout thos typ >I mqu s to the Tr� m.irk As 1st. ce Center.
iwev pie
be w.ire tt,Jt nMH group c.in >v1de .iny s?-lt of mf '11ilb mt� n.iture 1f "!(>9� .idvi • Ft leg.ii Mee. �e.ise C( �di contKting .ir ttorney who Cl res In �Hee I proi rty.
• Bua Report: Report any "bugs" found within the electronic fonns on the USPTO's website.
• Stalus Information: For an application with an assigned serial number, check the Trademark Status & Document Rctric\·al (TSDR) system to \·iew current ,tatus infom1ation. as well as dte complete prosecution history. Do nol
attempt 10 check the status of a filing until al least 7-10 days after submission of the filing. to allow sufficient time for all USPTO databases to be updated. You can \·iew all items )isled in the prosecution history section online Yia the
TSDR system. including all Office actions sent by the USPT0.

TL\fEOUT \VAR.NlNG: After 25 minutes of inactivity, you will be prompted to continue your session. If you do not continue within 5 minutes, the session will end, you will be logged out of your USPTO.gov account, and you will lose any
unsaved data in the fonn. Please ha,·e all of your infomrntion ready before you start.

1. Is au� Rllog this application?
Foreig n d
- omiciled owners/holders must ha,•e a U.S.-licensed attorney represent them before the USPT0 in any application- or registration-related filing. Infonnation about hiring a U.S.-liccnsed attomey can be found on
the USPT0 website.
®YesONo

2. (OPTION
. ...tl.) To upload a pre,·ioasly saved form ftle, first re,·lel'I· the USPTO's TEAS Help iastractions for accessing previoastv su·ed data and then use tbe "Browse ..." button below to access the form rue su·ed 011 your
computer.
WAR."\UG: Failure to follow the TEAS Help instmctions will result in the inability to edit your data.
Im ortant: Do NOT use the button below to u load an image file (for exam le. a s

cimcn . You must use the bulton that will be resented for that t

sc within the proper section of.the actualf�rm

Browse...

Continue
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Trademark Electronic Application System

Navigation History: 1.1:::!staJctiQ > � > Marte: > Gooos/Services/Rling Basis > Attorney/Dom. Rep./Correspondence > fee/Signature
Under the Paperwork Reduction Act of 1995 no persons are required to resJX)Od to a col lection of information unless it diSl)Eys a valid 0MB control number.
PTO Form 1479 (Rev 09/2006)
Approved for use through xx/xx/xxxx OMB Control No. 0651-0009

Trademark/Service Mark Fo1·m, Supplemental Register
Version 7.1
Mark Information

Before the USPT0 can register your mark. exactly what the mark is must be clear. You may present your mark in one of the following ways: {l) standard characters, if not claiming a particular font style, size. and/or color: (2) special form, if
the mark includes a design or word(s) combined with a design. or is displayed in a pa1ticular font style. size. and/or color: or (3) non-visual sound mark (for this type of mark, you should include a musical score. and an audio file. as well as a
detailed mark description). Do not upload your specimen of use (sample of actual use, e.g., a label or advertisement) here. This will be required in a different part of the form (if appropriate for your filing basis). WA.R!'\"ING: You may submit
only one mark per application. if your application includes muhiplc marks, it may be denied a filing date or refused registration.
When you click on one of the three circles presented below. and follow the specific instmctions, the fonn will automatically create a separate page that displays the mark for which you arc applying or pcnnits the applicant owner/holder to
anach an audio file for a sound mark. Please carefolly review this page prior to final submission to the USPTO, to ensure that it accurately depicts or represents your mark. You may not be pcrmined to change or correct your marl:: after filing
this application. While minor changes in the mark may sometimes be pennittcd, changes that result in a material alteration of the mark as originally filed will result in the USPTO issuing a refusal on that ground.
WARl\""lNG: AFTER YOU FINISH SEARCHING THE USPTO DATABASE FOR POTENTIALLY CONFLICTING MARKS, EVEN IF YOU THINK THERE ARE NO CONFLICTING MARKS. DO NOT ASSUME THAT YOUR
MARK WILL AUTOMATICALLY REGISTER. AFTER YOU FILE THE APPLICATION. THE USPTO WILL CONDUCT ITS OWN DATABASE SEARCH Af.H} COMPLEX LEGAL REVIEW. AND MAY REFUSE TO REGISTER
YOUR MARK ON THAT OR ANOTHER BASIS.
\Vatch the TI\1IN instructional \'ideo on the importance or conducting a search or existing trademarks or service marks before filing your application.
* Click the appropriate circle to indicate the i\brk type:@ Standard Charactcn O Special Form (Stylized and/or Design) 0 Sound mark
\Vatch the T1\UN instructional video on drawing issues.
Watch the TEAS Nuts and Bolts video explaining bow to fill out the Mark Information page.

Enter the mark here: (Note: The entry un be in upit;tl letters, lower use letters, or .i combination thereof. Do not include the -, •, ®, or O symbols aft.er the m.irk entry, beuuse they ;ue not p.irt of the .ictu.il mark. If using Internet Explorer, the
entry c.innot HCffd 2036 ch.ir.icters; otherw1se, you must switch to .inother browser.)

Preview USPTO-Geera
n ted Image

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NOTE: For how the USPTO dehmnines wh11t the dir.pl.iy of the entered m.irk will be, dick !:!!r!_.
NOTE: For lnform.ition .ibout m.irk displ.iy In USPTO daUb.ises, dick hirt
The "Additional Statement" section of1his fonn is used to enter various legal or infonnational statemcnt(s) that may pertain to the mark: for example, a disclaimer or English translation. You arc not required to enter any of these statcmcn1(s) at
the time of filing: however, you may be required to add a statcmcnt(s) to the record during examination of the application. If you arc unsure whether you should make such a statement. the examining attomey assigned to your application will
issue a requirement. if appropriate.
D Check here to display the full listing of additional statements from which you may make your selection.

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Trademark Electronic Application System

Navigation History: 1.1:::!staJctiQ > � > Mark> Goods/Services/Filing Basis > Attorney/Dom. Rep./Correspondence > Fee/Signature
Under the Paperwork Reduction Act of 1995 no persons are required to resJX)Od to a collection of information unless it diSl)Eys a valid 0MB control number.
PTO Form 1479 (Rev 09/2006)
Approved for use through xx/xx/xxxx OMB Control No. 0651-0009

Trademark/Service Mark Fo1·m, Supplemental Register
Version 7.1
Goods/Services Information

Instructions:

Step 1: Click on the appropriate button, below, to indicate whether you wish to create your listing of goods/senices by: (1) taking entries directly from the i'1anual of Trademark Acceptable Identifications of Goods & Services
(ID�fanual); or (2) enlering your own free-texl entry. NOTE: Option 1 is recommended because entries in the 1Di\1anual are generally acceptable as writlen; howeve[', if the entry ['equires customization through the insertion of
free-form text, en.a Option 1 obviously will not ensure that the listing is accepted.
Step 2: Click on the "Add Goods/Sen•ices" button.
Step 3: After creating the complete list of goods/senices for this application, you will then be able in the next section of the form to designate the filing basis (or bases) appropriate for each listed item.

1. Your selection of goods/sen'ices from the ID)fanual must accurately identify your goods/sen·ices. For additional information, see TMEP Chapter 1400. If you do not find a listing that accurately identifies your
goods/services, you may email TI\flDSUGGEST@uspto.gov to request that your identification be considered for addition to the IDi\Iaoual. Visit the USPTO?s website for information on IDMaoual suggestions. If your
request is appro,·ed, you must wait until the approved identification is added to the IDi\faoual. If your request is not approved or you wish to file immediately, you must use the TEAS Standard form.
2. Some entries include instructional language beneath the actual entry, within<> symbols. This language is only to assist in the proper selection of an entry, and will :KOT be included as part of the actual identification after
the checked entry is inserted into the form.
3. If you cannot access the ID)fanual through the "Add Goods/Services" button, try switching to another browser. If after changing browsers you still cannot access the IDManual through the "Add Goods/Services" button,
please contact TEAS@uspto.gov.
Tli\lEOUT \VAR N
. ING: Afler 25 minutes of inactivity, you will be prompted to continue your SHsion. II you do not continue within 5 minutes, the session will end, you will be loga;ed out of your USPTO.go,• account, and
you will lose any unsa,·ed data in t.he form. Please have all of your information ready before you start.
* Choose O:NE method for addini:; the Goods/Sen•ices: ® Searchini:; ID Manual O Eoterina: Free-form texl
NOTE - INSTRUCTIONAL VIDEOS AVAILABLE REGARDING GOODS/SERVICES:
Watch the TMIN Goods and Services video ex.plaining what is meant by "identification of goods and services", and watch the TEAS Nuts and Bolts: Goods and Services video for insimction.s on filling out the Goods/Services page in this
application.
Add Goods/Services

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Remove Checked Goods/Services

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NOTE: Clicking•co Bade" will �ke you directly back to the MARK section of the form.
Go Back

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Navigation History: .ln..sto.!ctiQn > � > .MaJ::k > Goods/Services/Filing Basis> Attorney/Dom. Rep.fCorrespondence > Fee/Signature

Under the Paperwork Reduction Act of 1995 no persons are required to respond to a collection of information un� it displays a valid 0MB control number.

PTO Form 1479 (Rev 09/2006)
Approved for use through xx/xx/xxxx OMB Control No. 0651-0009

Trademark/Service Muk Form, Supplemental Registe1·
Version 7.1

Watch the TMIN Filing Basis video explaining wbat is meant by ''basis for filing.''
Watch the TEAS Nuts and Bolts: Filing Basis video explaining how to fill out the Filing Basis page.

Basis for Filing

The applicant requests that the trademark/service mark identified on the preceding page be registered with the USPTO on the Supplemental Register for the goods/services displayed below.

Instructions for assigning a filing basis:

For each of the goods/services listed in the chart below, you will assign a specific filing basis, or if appropriate, multiple bases. (Ifthe list is incorrect, you can add or delete items, using the appropriate buttons, below.) Visit the
TEAS Help section of the USPTO website for an explanation oftlle three possible filing bases, identified by the 3 buttons beneath the listing ofgoods/services.
• Ooe class or mulllple classes2 with ONE filing basis ror ALL Usled llems ExampUs
NOTE: This is the most common choice. The following are other options, bu1 they are much less common:
• One class or mullll!le classes with same mulllRle fillo& bases ror ALL llsled Items In class(es} Examples
• One class or mullll!le classes wllh dlfferenl filln& basls(es) ror differenl aoods/servlces wlthio the same class and/or ror different onrall classes Ex,amples

* Choose ONE method ror adding the Coods/Sen'lces:@ Searching ID Manual O Enlerlng Free-form text

NOTE - INSTRUCTIONAL VIDEOS AVAILABLE REGARDING GOODS/SERVJCES:
Watc,b the TMIN Goods and Services video explaining what is meant by "identification ofgoods and services", and wa1ch the TEAS Nuts and Bolls: Goods and Services video for ins1ructions on filling out the Goods/Services
page in this application.

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Add Goods/Services
Visit lhe TEAS Help section of the USPTO website for instruclions on how lo add ilem{s) to lhe list
displayed below.

!ill 1 lnteroatlonal I
Class
5elect All1
[Graphic T-sh1rrs
025
Ill

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Remove Checked Goods/Services
Visil the TEAS Help section of the USPTO website for inslructions on how to remove item(s) from the
list displayed below.

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Goods/Sen•lces

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Assigned
Filing Basls(es)

NOTE: The 3 BUTTONS below Identify the choices or fillng basis to be assigned to lbe Items listed In the table, abo,·e. Because assignment or the correct basis to each Item Is critical, please read the e.xplanatlon or
each basis If you ban a11y quesllons as to which basis(es) to select, before cliddog lbe button(s)1 below1 to begin the assignment of the basls(es). Since assignment or a filing basis Is not a requirement within this form,
you can by-pass this step by clicking on the Continue button, below, if necessary.
WARNING: Registration Subject to Cancellallon for Fraudulent Statements
You must ensure that statements made in filings to the USPTO are accurate, as inaccuracies may result in the cancellation of a trademark registration. The lack of a bona fide intention 10 use 1he mark with an goods/services
included in an application. or the lack of use on all goods/services for whicb you claim use, could jeopardize the validity of the registration and resull in its cancellation.

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Section 1 (a)

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Section 44(d)

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Foreign application exists for same goods/servires

Actually lJSIOQ mark in commerce rw:,w

NOTE: dicking "Go Back" will takeyoudirectty back to the MARK section d the form.

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Go Back

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Continue

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Section 44(e)

Foreign registration exists for same goods/ser.'ices

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Navigation History: .ln..sto.!ctiQn > �> .Ma.!:k> Goods/SeJYices/Filino Basis> Attorney/Dom. Rep./Correspondence > Fee/Signature
Under the Paperwork Reduction Act of 1995 no persons are required to respond to a collection of information un� it displays a valid 0MB control number.
PTO Form 1479 (Rev 09/2006)
Approved for use through xx/xx/xxxx OMB Control No. 0651-0009

Trademark/Service Muk Form, Supplemental Registe1·
Version 7.1
Tip: If you do not want to appoint an attorney at this time:
l. Return to the first page of this fom1 by clicking on the hyperlinked tem1, "Instruction," in the Navigation History at the top of this page;
2. Answer "No" to the wizard question asking "Is an attorney filing this application?";
3. Click on the Continue button at the bottom of the Instruction page to resume the form. The Attorney Information page will not appear.

Attoruey Iufonuatlou
* Attornev Name
Indi\'idual Attorner Docket/Reference
Number

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NOTE: You must limrt your entry here to no more lhan 12 dlaracters.

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* Year or Admission Select Year

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* U.S. State/Commooweallb/IerrUorylselect State
* Bar Membership

* Membership Number
You must enter "N/A" ex- a membership number If your U.S.state, oommonwealth, ex- territory Issues one. This rumber ts not viewao4e In TSDR.
You must limit your entry here to no more than 40 alpharll.ffleflc d\aracters.

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* D The attorney of record is an active member in good standing of the bar of the highest coun of a U.S. state. the District of Columbia, or any U.S. Colllillonweallh or territory.

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Ulber AJ;rnolnted Attornev{s}
Recognized Canadian
AUornev/Agenl

Firm Name

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NOTE: You must limit your entry here, and for all remaining fields Within this overall section (except Oty, see f.lebH-1, to no more than 40 characters (the storage limit fcx- the USPTO database). You may need to abbreviate some

Internal Address
* Street Address

words, e.g., st

*Qtt

instead of street. Failure to do so may result in an oodeliverable address, due to truncaoon at the 40 character limit

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NOTE: You must limit your entry here to no more lhan 22 dlaracters.

* State
(Required for us. addresses)

ISelec1 State

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NOTE: You must include as part d the "Oty" entry any Information related to geographical regklns (e.g., provinces) not found ifl the dropdown lists for -states" or '"Countries.� Enter the CXV and then the geographic.al region,
separated by a comma (e.g., Toronto, ontano}. In most Instances, you Will then also haYe to select the oountry Within whldl the region ts found, below.

* Countrv/Region/Ju.risdiction/U.S.
TerrilOn'

ISelect Country/Region/Jurisdicrion/U.S. Territ, vJ

Phone Number

IUnited States

* Zip/Postal Code
(Required for us. and cert.lin intematkmal
addresses)

Fax Number

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IEx1.c=:J
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The appointed attorney's email address must be provided and kept current with the USPTO.
NOTE: The applicant owner/hOlder or the applleant owner's/hOlder's attorney acknowledges that he or she is so6ely responsible for reoetvlng USPTO emails. Add1tl0naly, the appllcant owner/holder or the applicant
owner's/hOlder's attorney Is responsible for penoclk:ally checking the status of the applic:atlOn/reglStratlorl USing the Trademar'.: Status & OOOJnent Retrieval QSDR) system. USPTO notices and office ac:uons ISsued In thlS
applicatioo/regtstratlon can be viewed onlloe using TSDR. The USPTO Is not responsiblefor any failure to receive a USPTO-lssued ematl due to the receiver's security ex- antl•spam software, or ?iff'f problems with the receiver's
email system.

* Email Address

.___
G_ _
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PATENT ANO TRADEMARK OFFICE

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Navigation History: .ln..sto.!ctiQn > � > .Ma.!:k > Goods/SeJYices/Filino Basis> Attorney/Dom. Rep./Correspondence > Fee/Signature

Under the Paperwork Reduction Act of 1995 no persons are required to respond to a collection of information un� it displays a valid 0MB control number.
PTO Form 1479 (Rev 09/2006)
Approved for use through xx/xx/xxxx OMB Control No. 0651-0009

Trademark/Service Muk Form, Supplemental Registe1·
Version 7.1
Co1Tespoudence Information
Watch 1he TEAS Nuts and Bolts: Correspondence Information video on the USPTO website for instructions on this page.
To make changes to the Primary Email Address for Correspondence below, either
( 1) return to the Applicant Information section (if no attorney bas been appointed) and enter the change, or
(2) use the Attorney Information section of the form to enter the change (if an attorney has been appointed).
Name

Email Address

Primary Ema.ii Address for Correspondence:
Secondary Email Address(es) (Courlesy Copies) I
Enler up to 4 addresses. separated by either a semicolon or a comma.
Only the Primary Email Address for Correspondence is used for official communication by the USPTO. If an attorney has been appointed, lhe USPTO will correspond
ONLY wi1h the appointed altoruey; otherwise the USPTO will correspond with the applicant owner/holder. The applicant owner/holder or the appointed attorney must keep
this email address current with the USPTO.
NOTE: I uodefstand that (1) a valid emarl address must be maintained by the applicant owner/holder and the applicant owner'sfhokler's attorney, if appointed, for CDrrespondence and (2) all offldal trademark
oorrespondeflce must be submitted via the Trademark Electronie ApplieatiOn System (TEAS).

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Rep /Corresoondeoce > Fee/Signature

Under the Paperwork Reduction Act of 1995 no persons are required to respond to a collection of information un� it displays a valid 0MB control number.

PTO F orm 1479 (Rev 09/2006)
Approved for use through xx/xx/xxxx OMB Control No. 0651-0009

Trademark/Service Muk Form, Supplemental Registe1·
Version 7.1

Fee Information
The total filing fee is based on the number of classes of the goods/services listed in the application.
If you used the free-text approach for the goods/senrices, and have different filing bases within the same class, then the displayed Number of Classes and Total Fee Due will be inaccurate belO\v. In that case, you must
manually change the Total Fee Paid amount, using the pull-down box to select tbe correct fee amount.
Watch the TEAS Nuts and Bolts: Fee/Signature Information video for an explanation of how to fill out the fee and signature information sections.
Payment options: You will have three payment options (credit card, automated de11:osit account, and Electronic Funds Transfer). These options wHI appear after completing and validating this form.
Number of Classes

1 (Class: 025)

Fee per class

$275

* Total Paid Fees

S275

Total Fee Due

$275

Signature Information

Click to choose O!'lrrit signature method:

@ Sign directlv O Email Text Form to second party for signature O Handwritten pen-and-ink signature O Submit application unsigned

Elecn·oolc Signature

electronically sign this application. enter any alpha/numeric characten; (letten/numbers) of your choosing, preceded and followed by the forward slash(/) symbol. Most signatories enter their name between the two forward slashes; examples of
acceptable •signatures n include: /john doe/; /jd/; or /123-4567/. The application may still be Yalidated to check for missing information or errors even if the signature and date signed fields are left blank; however, you must specifically click the button for
"Submit application unsigned: above.

To

DECLARATION
Read the following statements before signing. Acknowledge the statements by checking the boxes and signing below.
D Basis:
If the applicant is filing the application based on use in commerce under 15 U.S.C. § 1051(a):
•
•
•
•

The signatory believes that the applicant is the owner of the trademark/service mark sought to be registered;
The mark is in use in commerce on or in connection with the goods/services in the application;
The specimen(s) shows the mark as used on or in connection with the goods/services in the application; and
To the best of the signatory's knowledge and belief, the facts reci1ed in 1he application are accurate.

A.ND/OR
If the appllt.ant is filing the .application based on .an Intent to use the mark In commerce under 15 U.S.C. § 1126(d) and/or§ 1126(e):

• The signatory believes that the applicant is entitled to use the mark in commerce;
• The applicant has a bona fide intention to use the mark in commerce on or in connection wi1h the goods/services in the application; and
• To the best of the signatory's knowledge and belief, the facts reci1ed in 1he application are accurate.

D To the best of 1he signatory's knowledge and belief, no other persons, except, if applicable, concurrent users, have the right to use the mark in commerce, either in the identical form or in such near resemblance as 10 be
likely, when used on or in connec1ion with 1he goods/services of such other persons, to cause confusion or mistake. or to deceive.
D To the best of 1he signatory's knowledge, informa1ion, and belief, fomled after an inquiry reasonable under the circumstances, the allegations and 01ber factual contentions made above have evidentiary suppon.

D The signatory being warned that willful false statements and the like are punishable by fine or imprisonment. or both, under 18 U.S.C. § 1001, and that such willful false statements and the like may jeopardize the validity
of the application or submission or any registration resulting therefrom, declares that all statements made of his/her own knowledge are true and all statements made on information and belief are believed to be true.
* Signature

* Slgnaton·'s Name
* Slgnaton's Position

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* Date Signed l

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NOTE: The signatory must provide their first and last name. Use the following fonnat: Last Name, First Name Middle Initial or Name, if applicable.

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Enter appropriate title or nature of relationship to the owner/bolder.
If the signer is
- An individual owner/bolder, enter "Owner" or "Holder" as appropriate.
- Joint tudil'ldual owners/holders. enter "Owners" or "Holders" as appropriate (all must sign the fom1).
- A business entity authorized signatory, enter official title; e.g., ''President" (if a corporation),"General Partner" (if a partnership), or "Principal" (if a Limited liability
company).
- A U.S..licensed attorney, enter ''Attorney of record," and if not specified in the application or prior communications, specify at least one state bar admission, e.g..
"Attorney of record, New York Bar member." Also, if the signing attorney is from the same U.S. finn as the attorney of record, but was not listed in the original filing and is
not otherwise of record. also include law finu name, e.g., Associate Attorney. Smith, Jones & Davis, Virginia Bar member.

if

Slgnaton's Phone Number Iunited States

"II

IEx1i==!

JI

t Signature process. otherwise, Cid(. on the Validate button, or if necessary, the Go Back button.
atones did: on the •Add�natory" buttofl below, and r
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k
Add Signatory
Validate
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Navigation History: Instruction > Applicant > Marie > Goods/Services/Filing Basis > Attorney/Dom. Rep./Correspondence > Fee/Signature
Under the Paperwork Reduction Act of 1995 no persons are required to respond to a collection of information unless i t displays a valid 0MB control number.

PTO Form 1479 (Rev 09/2006)
Approved for use through xx/xx/xxxx OMB Control No. 0651-0009

Trndemark/Service Mark Form, Supplemental Registe1·
Ve,�iou 7.1 - Validation Page
IMPORTA.'l'\"T: Ou Fri Dec 13 08:06:08 ET 2019, you completed all mandatory fields and successfully nlidated the form. It bas N'OT yet been filed with the USPTO at this point. Complete au the steps below to
submit the application to the USPTO.
Watch the TEAS Nuts a.nd Bolts: Validation Page video for instructions on filling out this page.

■ STEP 1: Review the application data in the various formats below by clicking on the hyperlinks under "Application Data." Use the print function in your browser to print these pages for your own records. Visit the USPTO'S
TEAS Help webpage for information on correcting your image when the Mark and Specimens appear huge in the provided hyperlinks.

Nole: Review this information for accuracy and completeness now. Corrections after submission may not be allowed, thereby possibly affecting your legal rights.

■STEP 2: If there are no errors and you are ready to file, confirm the Primary Email Address for Correspondence, displayed below. To make changes to this email address, use the navigation buttons below to rerurn to the
appropriate page in the form and update ei1ber rbe attorney's email address, if appointed, or the applicant owner's/holder's email address. Courtesy copies are also permitted and these email address(es) are displayed below. To
update these addresses, use the navigation buttons below to return to lhe Correspondence Infonnation page and enter the changes.

After you submit the form, the USPTO will send an acknowledgment of receipt to the following email address(es):
Primary Email Address for Correspondence:
Secondary Email Address(es) (Courlesy Copies):

■ STEP 3: To download and save lhe fonn data, click on the "Save Form" button at the bottom of this page. The infonnation will be saved to your local drive. To begin the submission process with saved data, you must open a

new form, and click on the "Browse/Choose File" bmton displayed on the initial form wizard page, at "(OPTIONAL] To access previously-saved dala, use lhe "Browse/Choose FIie" bullon below lo access the file from
your local drive." REMl1''DER: Do NOT try to open the saved .obj/.xml form directly. You must return to the very first page of the form, as if starting a brand new form, and then use the specific "Browse/Choose File" button
on that page to import the saved file. Clicking on the "Cominue" bmton at the bottom of that first page will then properly open the saved version of your fonn.

■ STEP 4: Read and check the following:
lmportanl :"J"ohce:
(1) Once you submit this application, we will not cancel the filing or refund your fee. The fee is a processing fee, which we do not refund even if we cannot issue a registration after our substantive review. This is true
regardless of how soon after submission you might attempt to request cancellation of the filing. Therefore, please review ALL information carefully prior to transmission.

(2) All information you submit to the USPTO at any point in the application and/or registration process will become public record, including your name, phone number, email address, and street address. By filing this
application, you acknowledge and agree that YOU HAVE NO RIGHT TO CONFIDENTIALITY in the information disclosed. The public will be able to view this information in the USPTO's on-line databases and through
internet search engines and other on-line databases. This information will remain public even if the application is later abandoned or any resulting registration is surrendered, cancelled, or expired. To maintain
confidentiality of banking or credit card information, only enter payment information in the secure portion of the site after validating your form. For any information that may be subject to copyright protection, by submitting it
to the USPTO, the filer is representing that he or she has the authority to grant, and is granting, the USPTO permission to make the information available in its on-line database and in copies of the application or
registration record

(3) Be aware that private companies not associated with the USPTO often use trademark application and registration information from the USPTO's databases to
non-USPTO solicitations included).

mail or email trademark-related solicitations (samples of

D If you have read and understand the above notice, please check the box before you click on the Pay/Submit button.
■STEPS: If you are ready to file electronically:
Click on the Pay/Submit button below, to access the site where you will select one of three possible payment methods. After successful entry of payment information, you can complete the submission to the US PTO. A valid
transaction will result in a screen that says SUCCESS! Also, we will send an email acknowledgment within 24 hours.
WARNING: Click on the Pay/Submit button ONLY if you are now entirely prepared to complete the Pay/Submit process. After clicking the button, you can :r'\OT return to the fonn, since you will have left the TEAS site

entirely. Once in the separate payment site, you must complete the Pay/Submit process within 30 minutes. If you are not prepared to complete the process now, you should select the "Save Form" option to save your form, and
then complete the Pay/Submit process later. Or, if you have discovered any error, use the "Go Back to Modify" button to make a correction.

WARl\'ING: Fee payments by credit card may not be made from 2 a.m. to 6 a . m .Sunday, Eastern Time. If you are anempting to file during that specific period, you must use either (l) the deposit account or electronic funds
transfer payment method; or (2) the "Save Fonu" option 10 save your form, and then complete 1he Pay/Submit process later for a credit card payment.

Go Back to Modify

Save Form

Pay/Submit

Burden/Privacy Statement I TEAS Form Burden Statement I Bug Report/Feedback I TEAS Home

PRA Act Statement
This collection of information is required by 37 CFR 1.137. The information is required to obtain or retain a benefit by the public
which is to file (and by the USPTO to process) an application. Confidentiality is governed by 35 U.S.C. 122 and 37 CFR 1.11, 1.14
and 41.6. This form is estimated to take 45 minutes to complete, including gathering, preparing, and submitting the completed
form to the USPTO. Time will vary depending upon the individual case. Any comments on the amount of time you require to
complete this form and/or suggestions for reducing this burden, should be sent to the Chief Administration Officer, U.S. Patent
and Trademark Office, U.S. Department of Commerce, P.O. Box 1450, Alexandria, VA 22313-1450. DO NOT SEND FEES OR
COMPLETED FORMS TO THIS ADDRESS. SEND TO: Mail Stop Petition, Commissioner for Patents, P.O. Box 1450,
Alexandria, VA 22313-1450.

Privacy Act Statement
The United States Patent and Trademark Office (USPTO) collects this information under authority of 5 CFR 339.205. The
information in this system of records is used to manage name, citizenship, domicile, email address, postal address, and telephone
number of the trademark applicant, registrant, and applicant’s or registrant’s legal or other authorized representative(s), an
attorney’s law firm or company affiliation and professional licensing information, and other information pertaining to an
applicant’s or registrant’s activities in connection with the applied-for or registered mark. Other records mange in this system
include trademark applications, applicant and registrant declarations, office actions, registration certificates, and correspondence
generated in the course of the prosecution of a trademark application or maintenance of a trademark registration. The
information you provide is protected from disclosure to third parties in accordance with the Privacy Act. However, routine uses
of this information may include disclosure to the following: public; foreign entity, professional organizations or associations,
audit or oversight; governments, law enforcement and investigation; non-federal personnel; record informational inquiries; data
breach notification; data breach assistance; adjudication and litigation; department of justice litigation; freedom of information
act assistance from department of justice; office of personnel management; congressional inquiries; the National Archives and
Records Administration; and office of management and budget. Disclosure of the information by you is voluntary; however,
failure to provide any part of the requested information may result in our inability to enroll you in the program. The applicable
Privacy Act System of Records Notice for this information request is COMMERCE/USPTO-26, Trademarks Application and
Registration Records: Federal Register vol. 85 February 18, 2020, p 8847, available at https://www.govinfo.gov/content/pkg/
FR-2020-02-18/pdf/2020-03068.pdf