PTO Form 1482 Collective Trademark/ Service Mark Form, Principal Regis

Applications for Trademark Registration

TM-Form-MEF-Collective-Trademark-Service-Mark-Form

Use-Based Trademark/Service Mark Applications (TEAS Standard-Individuals or Households)

OMB: 0651-0009

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0651-0009 can be found here:

Document [pdf]

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Trademark Electronic Application System

Navigation History: Instruction > Applicant > Mark > Goods/5ervires/Aling Basis > Attorney/Dom. RepJCClrTespondeoce > Fee/Signat\Ke
Under the Paperwork Redurooo Art of 1995 no persons are required to respond to a oollection of information unless it displays a valid 0MB oontrol number.
PTO Form 1482 (Rev 09/2006)
Approved for use through xx/xx/xxxx OMB Control No. 0651-0009
Collective Trademark/Service Mark Form, Principal Register
Version 7.1
"'atch the "Before you fUe" DIIN ,ideo for ilD onn·iefl• of the most importirnt issues to be ilWll.re of when rtl.in& ii trademark ,application with the USPTO.

To fiJe the ilppliu,tion eledrooic.alty, plu,se complete the followina: steps:

6
7
8

9.
10.

Answer the first question �low to create an application form showlilg only sections n:le\.wt to your specific filing
For help at any point. click on any Wldn-lined word on any page
Afte-r answe-ring the first wizard question. dick on the CO:'.'IITINUE button at bottom oftbe page
Once in the actual form. c omplete all fie lds with a• symbol sinc e the y arc mandat ory fie lds for TEAS filing purposes.
Validate the form, using the "Validate" buno n at the end of th e form. If there arc errors, re turn to the form to mak e th e correction. A "Warning" may be co rrected or b)'-passcd.
Double-check all entries thrnugh th e links dis played on the \.alidation page
You may s;l.\" e yo ur work for submission at a later time by clicking on the Sa\·e Form bulto n at the bolto m ofthe Validation page
When ready 10 file , use the Pay/Submit bunon at the boltom of the Validation page . This will allow you to choo se from du:ec (3) different payment me thods: credit card, automated d eposit account, or electronic funds transfer
After accessing the proper scre e n for payme nt. and making the appro priate entries, you will rece i\· e a confirmati o n screen if your transmission is successful. This screen will say SUCCESS! and will pro,·idc your assigned serial number.
An email ackno wledging rece ipt ofthe submissi on (a filing receipt) will be sent to the correspondenc e email address of re cord.

Once you submit tbis application, tbe USPTO will 1101 ca.11cel the filing or refu11d your fee. The fee i s a processUlg fee, whicb we do 1101 refund e,·e11 if ft·e canllot issue a reiistra.tion after our substanth·e re,·iew.

l m porta11t: After this application is submine d, the USPTO will send a filing rece ipt to the email addre ss of either (A) the appointed anomey, if any, otherwise (B) the trademark applicant owner bolder
Contact Points:
• C.aeral tra.demark iaformatio11: Plea se r�·iew the information po sted at \Vhcrc Do I Start. Ifyou h;l\"c remaining questions, e mail TrademarkAssistanccCenta'lz:uspto.gov, or telephone 1-800-786-91991,,.
• Help: for mnn.icuons on how to �.se the elecuoruc forms, or help m resolnng tecl1tt/calghtchcs, pleue rma1l T EAS'uuspto 11 0 v . Please mclude your telephone number m your email. so we can talk to you directly, 1fneccssuy. Also, mcludc the rele\·ant scnal number or
rc1111uauon number, 1fex1Hmg
NOTl: fh TtAS �rt onf ,i$OnP,
otedtotlitpr Wev pl,,
.,. INtM ,g, Ctnp,w,dc
ttllect-ailpr ,ty
>rtof,n'< ,i . l:llc
rtof ,911.ct. f eo,a,l,a pa co,
cont, ·no -ttor
o
• But Report: Report any "bu115" fowld wtthm the electronic forms on the USPTO's website
• Slatus l•lormaUoa: For an applica11on with an assigned scnal number, check the Tn.dcmark Smus & Document Retn�·al (TSDR) sy11cm 10 new currcn1 status mformatton, u well as the complete prosccu11on history Do not attempt 10 check the status ofa filmg un1tl at least
7-10 days after subm1ss1on ofthe filmg, to allow sufficient lime for all USPTO databues to be updated You can new •II 11ems hstcd m the prosecution bntory section onhnc na the TSDR system. mcludm11 all Office ac11ons sent by the USPTO

TL\lEOUT W��u11·c: After 25 minutes ofinactivity you will be prompted to continue your session. Ifyou do not continue within 5 minutes, the session will end, you will be loa@ed out ofyow- USPTO.110,· account, and you will lose any unsaved da1a in the form. Please ha\·e all of
your information ready before you start.
J. ls an !.!!.2.!:!!l:: flllaa tbls applludoa?
[on:lia•don1klltd 011·ners/lloldtn must hn • U.S.-llctased anorary rtprtstnt lbem bdort 1be USPTO m any applic:11100- or regisua1ion•relared filing. Information about hinngaU-S-•licenscd attorney can be found on the USPTO website.
@Ycs0No
2. (OPTIONAL) To upload a prniously sand form rue, Orsi n.,iew Ille USPTO's TEAS Help UIStructlons for accessingpn:,ioush· sand data and tllen as. tb.e "Browse .. ., buno■ ti.low lo access Ille form rue sand on �-our computer.
WARi\T\"G: Failw-e to follow the TE.l,.S He lp instructions will result in the inability to edit your data

Jmporta■t: Do NOT us e the bunon below to uplo ad an image file (for e:umplc, a spcc1111en). You must use the button that wtll be presente d for that purpose within the proper section oft�actualform

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Trademark Electronic Application System

Navigation History: l..a:itn!!:tlQn > Applicant > Mark > Goods/5ervire5/Fi ling Basis > Attorney/Dom. Rep./CCN'Tespondence > Fee/Signattre
Under the Paperwork Redurooo Art of 1995 no persons are required to respond to a oollection of information unless it displays a valid 0MB oontrol number.
PTO Form 1482 (Rev 09/2006)
Approved for use through xx/xx/xxxx OMB Control No. 0651-0009
Collective Trademark/Service Mark Form, Principal Register
Version 7.1
"'atch the TI\UN "Applin.DI information" ,ideo th.at explains the terms "applicant" or "applicant ownei-/hoJOO_• The term •applicant" identifies who owns the trademark, not necesrnily who is filing the applic:.i.tion_
Watch the TEAS !'iuU and Bolts Applicant Information ,·ideo tm.1 e;,tplains how to fill out the Applicant Inform:a.tion page

Applicant Information
N"ote: Ifthere is more tb; 11n one ownu of the tndemark, complete the applicant information for the first ownel", and then click on the "Add Owner' button at the bottom ofthu page. Repeat for e:Kh owner. You must specify whethe£ the multiple applicants are joint applicants or some
other entity type listed below.

[lfanindMdual,w:ethefolowingformatust:Jurrw:o,Ant,._,,e�lnitillorN-,ifappia,bll:-]

0 DBA (doina; business u) 0 AKA (also known ;r,s)
0 TA (tndina; u) 0 Formerly
EntitvT\pe
0Indhidual
Ocorporalio11
0Limited Liabilitv Companv
0Partnership
0Llmlled Partnership
0Joinl Venture

<= Click the appropriate circle on the left to indicate the applicant's entity type. The form will then display the field(s) for enterina information correspondina 10 that
specific entity type. Ir your entity type is not one of the options displayed directly to the left, you must click on "Other" and then select the appropriate entry from the

0 Sole Proprietorship

rele,,ant pull-down box.

0Trust
OEstate
Oother

I
I

I111ernal Address
"'Street Address
(Entttrd.ddttH is IMWaW.. in tM IJSPTO'-.
TSDRdataba'Oe. .,_......,_.. ......t bee capable
of rff:f,h,in,g mail. The IJSPTO pttSUmes this
addttHi!I U...applicant -ner-./hokler·-.�
If it is not, fflter tlte DMnicile AddttH bdow.)

NOTE:Youmustirnityourentryhere,Mdfor alreona1nir19fieldswhinl!>i$overal$edxwl,tD110,_ethan40dia<¥ten:(thestoraoeimil.fortheUSPTOdlD.,_).YoumayneedtoabbreYiak--ds.,e.dudenp«t"'t!,e"Oty'"entryMYinfamwbonrout Ls

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Trademark Electronic Application System

Navigation History: l..a:itn!!:tlQn > � > Mark > Goods/5ervices/Fihng Basis > Attorney/Dom. Rep./C0rrespoodenoe > Fee/Signature
Under the Paperwork Redurooo Art of 1995 no persons are required to respond to a oollection of information unless it displays a valid 0MB oontrol number.
PTO Form 1482 (Rev 09/2006)
Approved for use through xx/xx/xxxx OMB Control No. 0651-0009

Collective Trademark/Service Mark Form, Principal Register
Version 7.1
Mark Ioformatioo
Before the USPTO can rcgis1er your mark, exactly what the mark is must be clear. You may present your mark in one of the following wa�: (1) standard cbarac1cn, 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 particular font style. size, and/or color-; or (3) non-\isual sound mark (for this type of mark, )'OU should include a musical score, and an audio file, as well as a de1ailed mark description). Do not upload your specimen of use (sample of actual use, e.g.. a label
or :.wh·ertisnncnt) here. This will� required in a diffo:filt p.ut ofthe form (if appropriate for your filing buis). WAR..,"'ING: You may submit only one mack pn application, ifyour application includes mu1tiplc marks, it may be drnied a filing date or refused registration
When you click on one of the three cir-des presented below, and follow the specific instructions, the form will automatically create a separate page th.at displays the mark for which you arc applying or permits the applicant owner/holder to attach an audio file for a sound mark_ Please
carefully rcYicw this page prior lo final submission to the USPTO. to ensure th.at it accw-ately depicts or rein-esents your mark. You may not be permitted to change or conectyour mark after filing this application. While minor changes in the mark may :som,uim£S � permitted. changes th.at
result in a materi.a1 altel"ation of the mark as originally filed will result in the USPTO issuing a refusal on th.at ground
WARNL.'\"G: AFTER YOU FINISH SEARCHING THE USPTO OAT ABASE FOR POTENTIALLY CONFLICTING MARKS. EVEN IF YOU THINK THERE ARE NO CO!\'FLJCTING �f..UK.S, DO NOT ASSUME TH.4..T YOUR MARK WILL AUTO�fA TI CALLY REGISTER
AFTER YOU Fll.E THE APPLICATION, THE USPTO WILL CONDUCT ITS OWN DATABASE SEAR.CH AND CO�1PLEX LEGAL REVIEW. AND �{AY REFUSE TO REGISTER YOUR MARK ON THAT OR ANOTHER BASIS.
\Vatch lhe TMIN instructional video on tbe importance of conducting a search of n:isling trademarks or sen·ice marks before filing your applicalion.
,. Click the appropriate circle to indicate the Ma.rk type: ® Standard Charac1en O Special Form (Stylized and/or D«sign) 0 Sound mark
\Yatcb 1be TIIIN in.structional video on drawing issues..
\Yatch lhe TEAS r\u15 and Bolls 1ideo ei:plsymbolslftf.fthelnltt;ffltry,beC1USClhey•enotp,rtoflhe1Ctull1Nlk.1fUW1glllffll\Ct&plofer,theentryCIMOl.eocttdZ036ch.-.cters;othefwise,yw
Preview USPTO-Generated Image

NOTE: For llowlheUSPTOdetenrmeswh.tthe�oflheffltf.fed ..,,l,;wil be, dd.�.
NOTE: For inform,_ about_.... display IllUSPTO d&ll>lses,. ddr. �
The MAdditioo.al Statemenl" section of this form is used to enter \'21ious lcga.l or informational st.atcmcnt(s) that may pertain 10 the mark; for a.ample. a disclaimer or English trarulation. You are not required to enter any ofthese statcment(s) at the time of filing; howe\·er. you may be
required to add a st.atement(s) to the record during examination of the applica1ion. If you arc unsure whether you should make such a statement. the examining attorney assigned to your application will issue a requirement, if appropriate
check here to display the full listing of additioo.al statements from which you may make your selection.

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Trademark Electronic Application System

Navigation History: l..a:itn!!:tlQn>�>Mart> Goods/services/Filing Basis> Attorney/Dom. Rep./correspondenre > Ftt/Signatu"e
Under the Paperwork Redurooo Art of 1995 no persons are required to respond to a oollection of information unless it displays a valid 0MB oontrol number.
PTO Form 1482 (Rev 09/2006) Approved for use through xx/xx/
xxxx OMB Control No. 0651-0009)

Collective Trademark/Service Mark Form, Principal Register
Version 7.1
Goods/Sen-ices Information

lnst['ucrioos:
Step I: Click on the appropriate button, IHWw, to indicate whether you wish to create your listing of good.$/senices by: (1) taking entries directly from the .Vanual of TrademarkAcuptabk Itkntifications ofGootb & St,.·ices ([D�hnm1I); or (2) ,nterin& your own free-tut
entry. NOTE: Option l i s recommended beuuse entries in lhe IDManual are generalty acceptable as written; bowenr, irtbe entry requires customization through the insertion of free-form tut, enn Option l ob,•iously will not ensure that tbe listing is accepled.
Step 2: Click on the "Add Goods/Sen·ices'' button.
Step 3: After crealing lhe complete list of goods/sen':ices for this application, you will then be able in the nut section of the form to designate the fi.liog basis (or bases) appropriate for each listed ilem.
NOTE:
l . Your selection o f goods/sen·ices from the IDMaa ual m ust accurately identify your goods/ sen;ces. For additional information, see TMEP Clllapter 1400. l f you do DOI find a listing that accurately Identifies your goods/stnices, you ma)· email
[email protected],· to request Ihat your identification be considered for addition to the ID:\lanual Visit lhe USPTO?s website for information on IDi\lanual suggestions. lf your request is apprond, �-ou must wait until the .apprond identific.ation is added to
the ID;\lanual lf your request is not .appro,·ed or you wish to file immedi.ately, you must use the TEAS Standard form.
Some entries include instruction.al l.angu.age beneath the .actual entry, within<> symbols. This langu.age i s only to .a ssist in the proper selection or.an entry, .and will NOT be included as part of1he actual identification aner the checked entry is inserted into the form.
3. Iryou cannot access the IDl\Ianual through the "Add Goods/Services" button, try switching to another browser. If aner changing browsers you still cannol access lhe IDManual through the "Add Goods/Sen·ices" button, please contact TEAS@uspto.:ov.
TIMEOUT WAR..r.,'"Th'G: After 25 minu1es of iucth•ih· you will be prompted to continue )·our s ession. If you do not coa1inue within 5 minutes, the s ession will end, you will be loued out of your USPTO.go,· account, and you will lose any unsand data in the form.
Please ba,•e .all of your Information ready before you st.art.
• Choose ONE method for addin1 Che Goods/Sen;ce.s: ®Searcbln1 ID Manual O Enterin1 Fru-form IHI
NOTE- L'\"STRUCTIONAL VIDEOS AYAILABLE REGARDING GOODS/SERVICES:
W.atch the TMIN Goods ;and Services ,'ideo e,r:.pb..ining wm1 i s munt by "iden1ifiu1ion of goods ill!d s en·ices�, md witch the TEAS Nuts ind Bohs: Goods ind Services \•ideo for instructions on filling out the Goodll"Services pige in this ipplicition
Removi Ch•:ked

Add Goods/Services

NOTE: OicD!9 "Go kl<" wil !Ke you dir«tly b.ck to 1M HAAK section vith� fwm.
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Trademark Electronic Application System

Navigation History: Instruction> Applicant> Mark> 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 it displays a valid 0MB control number.
PTO Form 1482 (Rev 09/2006)
Approved for use through xx/xx/xxxx OMB Control No. 0651-0009

Collective Trademark/Service Mark Form, Principal Registe1·
Version 7.1
Basis for Filing
Watch the TMIN Filing Basis video explaining what is meant by "basis for filing."
Watch the TEAS Nuts and Bolts: Filing Basis video explaining how to fill out the Filing Basis page.

The applicant requests that the trademark/service mark identified on the preceding page be registered with the USPTO on the Principal Register for the class(es) and goods/services entered 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. (lf the 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 of the four possible filing bases, identified by the 4 buttons beneath the listing of goods/services.
One class or molti(!le classes1with ONE filin1: basis for ALL listed items Examples
NOTE: This is the most corurnon choice. The following are other options, but they are much less corurnon:
One class or moltil!le classes1with same moltil!le filing bases for ALL listed items in class(es} Examples
One class or multiple classes, with dilferent filing basls(es) for dilferent goods/sen•ices within the same class, and/or for dilferent overall classes Examples
• Choose ONE method for adding the Goods/Servic,s: ® Searching ID Manual O Entering Free-form text
NOTE - INSTRUCTIONAL VIDEOS AVAILABLE REGARDING GOODS/SERVICES:

Watch the TMIN Goods and Services video explaining what is meant by "identification of goods and seivices". and watch the TEAS Nuts and Bolts: Goods and Services video for instmctions on
filling out tl1e Goods/Services page in this application.

Add Goods/Services
Visit the TEAS Help section of the USPTO website for instructions on how to add item(s) to
the list displayed below.
IInternatlonall
Class

Iii
Select
Alli

IISilk cloth

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

I Filing Basis(es)

Goods/Se1vices

I
I read
NOTE: The 4 BUTTONS below identify the choices of filing basis to be assigned to the items listed in the fable, abo1,•e. Because assignment of the correct basis to each item is critical, please
the explanation of each basis If you have a11y questions as to which basls(es) to select, before clicking the bulton(s), below, to begin the assignment of the basls(es). Since assignment of a
G2I

024

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 Cancellation 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 to use the mark
with all goods/seivices included in an application, or the lack of use on all goods/services for which you claim use, could jeopardize the validity of the registration and result in its cancellation.

Section 1 (a)

Actually using mark in convnerce now

Section 1(b)

No use of mark yet, intending to use

Section 44(d)

Foreign application exists for same gcxxls/services

Section 44(e)

METHOD OF CONTROL

For a Section l(a) basis, the appUcaot controls the members' osr orthe mark lo the following manner (e.g., the appUcant's bylaws specll'y the manner or control):
• Method of Control

,_,,w:!!/li l tae,
NOTE: ,cOicl Applicant> Mark> 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 it displays a valid 0MB control number.
PTO Form 1482 (Rev 09/2006)
Approved for use through xx/xx/xxxx OMB Control No. 0651-0009

Collective Trademark/Service Mark Form, Principal Registe1·
Version 7.1
Tip: If you do not want to appoint an anorney at this time:
1. Rerurn to the first page of this fonn by clicking on the hyperlinked term, "lnstmction," in the Navigation History at the top of this page;
2. Answer "No" to the wizard question asking "Is an anomey filing this application?";
3. Click on the Continue button at the bottom of the lnstmcrion page to resume the fonn. The Attorney Information page will not appear.

Attorney Information
I

* Attornev Name
Individual Attornev
Dockt't/Rtfertnce Number

I
NOTE: You must limit your entJy here to no more than 12 characters.

• Year or Admission Select Year

• U.S. StaMCommouw,alth/fenitory Select State
* Membership Numbrr I

* Bar Membership

You must enter ·N/A. or a membership number if your U.S. state, common1Nealth, or territory issues one. This number is not viewable in TSDR.
You must limit your entry here to no more than 40 alphanumeric characters.

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

Other Am1ointed Attorney(s)
Recognized Canadian
Attoruev/�ent

Firm Name

Internal Address

I
I

* St.-f'f't Address

NOTE: You must limit your entry here, and for all rernaining fields within this overall section (except Qty, see below), to no more than 40 characters (the storage limit for the USPTO database). You
may need to abbreviate some words, e.g., st. il'Nead of street. Failure to do so may result in an undeliverable address, due to truncation at the 40 character limit.

• Citv

NOTE: You must limit your entry here to no more than 2.2 characters.

* State

ISelect State

* Countrv/Region/Jurisdictiou/U.S.
Tenitorv

ISelect Country/Region/Jurisdiction/U.S. Territ, vi

(Required for U.S. addresses)

NOTE: You must include as part of the •oty" entry any information related to geographical regions (e.g., provinces) not found in the dropdown lists for "states" or •eountnes: Enter the city and then
the geographical region, separated by a comma (e.g., Toronto, Ontario). In most instances, you will then also have to sek!ct the country within which the region is found, be.>w.

* Zip/Postal Code

(Required for U.S. and certain
international addresses)

Phone Number

IUnited States

vii

IExt.�
I

Fax Number

The appointed attorney's email address must be provided and kept current with the USPTO.

* Email Address

NOTE: The applicant owner/holder or the appficant owner'sfholder's attorney acknowledges that he or she is solefy responsible for receiving USPTO emails. Additionally, the applicant owner/holder or
the applicant owner's/holder's attorney is responsible for periodically checking the status of the application/registration using the Trademark Status & Document Retrieval (TSDR) system. USPTO
notices and office actions issued in this application/registration can be viewed online using TSDR. The USPTO is not responsible for any failure to receive a USPTO-issued email due to the receiver's
security or anti-spam software, or any problems with the receiver's email system.

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Trademark Electronic Application System

Navigation History: Instruction> Applicant> Mark> Goods/Services/Filing Basis> Attorney/Dom. Rep./Correspondence> Fee/Signature

Collective Trademark/Service Mark Form, Principal Register
Version 7.1
Correspondence Information
Watch the TEAS Nuts and Bolts: Correspondence Information video on the USPTO website for instructions on this page.
To make changes to the Primary Email Address fot· Correspoodtoce below, either
( 1) rerurn to the Applicant Information section (if no anorney 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
Primary Email Address for Correspondruce:
Serondari Email Address(es) (Courtesy Coe ies)
Email Address

IEnter up to 4 addresses, separated by either a srmicolou or a comma.

Only the Primary Email Address for Correspondence is used for official connnmtication by tl1e USPTO. If an attorney has been appointed. the
USPTO will correspond ONLY with the appointed attorney; otherwise the USPTO will correspond with the applicant owner/bolder. The applicant
owner/bolder or the appointed attorney must keep this email address current with the USPTO.
NOTE: I understand that (1) a valid email address must be maintained by the applicant ownerfholder and the applicant owner'sfholder's attorney, if appointed, for correspondence and (2.)

all official trademark correspondence ml& be submitted via the Trademark Electronic Application System (TEAS).

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Trademark Electronic Application System

Navigation History: Instruction > Applicant > Mark > 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 it displays a valid 0MB control number.
PTO Form 1482 (Rev 09/2006)
Approved for use through xx/xx/xxxx OMB Control No. 0651-0009

Collective Trademark/Service Mark Form, Principal 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 tl1e free-text approach for the goods/services, and have diffuent filing bases within the same class, then the displayed Number of Classes and Total Fee Due will be inaccnrate below.
In that case, you must manually change the Total Fee Paid amount, using the pull-down box to select the 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 deQQsit account, and Electronic Funds Transfer). These options will appear after completing and validating this form.
1 (Oass: 024)

Number of Classes
Fee per class

$275

* Total Paid Fees

$275

Total Fee Dne

$275

Signature Information
Click to choose ONE signature method:
@Sign directly O Email Text Form to second partv for signature O Handw1itten pen-and-ink signature O Submit application unsigned

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

DECLARATION
Read the following statements before signing. Acknowledge the statements by checking the boxes and signing below.
D Basis:
Ifthe 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 collective trademark/service mark sought to be registered;
The applicant is exercising legitimate control over the use of the mark in commerce by the members in connection with the goods/seivices in the application;
The specimen(s) shows the mark as used by the members on or in connection with the goods/seivices in the application; and
To the best of the signatory's knowledge and belief, the facts recited in the application are accurate.

AND/OR

Iftbe applicant is filing the application based on an intent to use the mark in commerce under 15 U.S.C.§ 1051(b),§ 1126(d), and/or§ 1126(e):
The signatory believes that the applicant is entitled to exercise legitimate control over the use of the mark in commerce by the members;
The applicant has a bona fide intention to exercise legitimate control over the use of the mark in commerce by the members on or in connection with the goods/seivices in the
application; and
To the best of the signatory's knowledge and belief, the facts recited in tl1e application are accurate.
D To the best of the signatory's knowledge and belief, no other persons, except the members, and, if applicable, concurrent users, have the right to use the mark in commerce, either in the
identical form or in such near resemblance as to be likely, when used on or in connection with the goods/setvices of such other persons, to cause confusion or mistake, or to deceive.

D To the best of the signatory's knowledge, information, and belief, formed after an inquiry reasonable under the circumstances, the allegations and other facnial contentions made above have

evidentiary support.

D The signatory being warned that willful false statements and the like are punishable by fine or imprisomnent, 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 rme and all statements made
on information and belief are believed to be true.

* Signature
* Sigoatorv's Name

• Date Signed_11

l(MM/00/YYYY)

NOTE: The signatory must provide their first and last name. Use the following fom1at: Last Name, First Name Middle Initial or Name, if applicable.
* Sigoato1y's Position
Enter appropriate title or nature of relationship to the owner/holder.
If the signer is
- An iudh idual owner/holder, enter "Owner" or "Holder" as appropriate.
- Joint individual ownus/holders, enter "Owners" or "Holders" as appropriate (all must sign the form).
- A business entity authorized signatory. enter official title; e.g .• "President" (if a corporation),"General Partner" (if a parmership), 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. fim1 as the attorney of record, but
was not listed in the original filing and is not otherwise of record, also include law firm name, e.g., Associate Attorney, Smith, Jones & Davis,
Virginia Bar member.
1

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Trademark Electronic Application System
Navigation History: Instruction > Applicant > Mark > Goods/Services/Filing Basis > Attorney/Dom. Rep./Correspondence > Fee/Signature

Collective Trndemadleted all mandato1y fields and successfully validated the form. It has NOT yet been filed with the USPTO at this point.
Complete all the steps below lo submit the application to the USPTO.
Watch the TEAS Nuts and Bolts: Validation Page video for instructions on filling out Ibis 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.
Note: 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 Prima1y Email Address for Correspondence, displayed below. To make changes to this email address, use the navigation
buttons below to return to the appropriate page in the form and update either the 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 the Correspondence lnfomiation page and enter the changes.
After you submit the form, the USPTO will send an acknowledgment of receipt to the following email address(es):
Prima1y Email Address for Correspondence:
Seconda1y Email Address(es) (Com1esy Copies):
• STEP 3: To download and save the form data, click on the "Save Form" bmton at the bottom of this page. The information will be saved to your local drive. To begin the submission process with
saved data, you must open a new fonn, and click on the "Browse/Choose File" button displayed on the initial form wizard page, at "[OPTIONAL] To access previously-saved data, use the
"Browse/Choose File" button below to access the file from your local drive." REMINDER: Do NOT try to open the saved .obj/.xml form directly. You must return to the very first page of the
form, as if staning a brand new form, and then use the specific "Browse/Choose File" button on that page to impon the saved file. Clicking on the "Continue" button at the bottom of that first page
will then properly open the saved version of your form.
• STEP 4: Read and check the following:
Important Notice:
(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 mail or email trademark
related solicitations (samples of non-USPTO solicitations included).
D If you have read and understand the above notice, please check the box before you click on the Pay/Submit button.
• STEP 5: If you are ready to file electronically:
Click on the Pay/Submit bunon 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 USPTO. 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 NOT return to the form, 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.
WARNING: Fee payments by credit card may not be made from 2 a.m. to 6 a.m. Sunday, Eastern Time. If you are attempting to file during that specific period, you must use either (I) the deposit
account or electronic funds transfer payment method; or (2) the "Save Form" option to save your form, and then complete the 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 40 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; nonfederal 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

File Type	application/pdf
Subject	Screen Capture by Snagit
Author	Snagit User
File Modified	2021-02-25
File Created	2019-12-16