Form PTO-2132 Application for Subsequent Designation

Madrid Protocol

0051 PTO-2132 TM-TEAS-Application for Subseqent Designation

Application for Subsequent Designation (Private Sector)

OMB: 0651-0051

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PTO-2132
Approved for use through XX/XX/20XX. OMB 0651-0051
U.S. Patent and Trademark Office; U.S. DEPARTMENT OF COMMERCE
Under the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it contains a valid OMB control number.

Application for Subsequent Designation





INSTRUCTIONS FOR SUBSEQUENT DESIGNATION


NOTE:  If you have installed Anti-Spam filters or software on your email service, please ensure that legitimate emails from [email protected] are not falsely identified as spam or junk.

  1. Information about Madrid System:
    To view the information provided by the International Bureau (IB) of the World Intellectual Property Organization (WIPO) concerning the Madrid System for the international registration of marks, click Madrid System for the International Registration of Marks.

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  3. To file the form electronically, please complete the following steps:

    • Complete all fields for which information is known.  Fields prefaced with an asterisk (*) are required fields for filing purposes and must be completed.

    • Use the Pay/Submit button at the bottom of the Validation Page. After accessing the proper screen for payment and making the appropriate entries, you will receive a confirmation screen if your transmission was successful.

    • You will also receive an email acknowledgement of your submission providing a summary of your filing.  Please contact [email protected] within 24 hours of transmission (or by the next business day) if you do not receive this email acknowledgement.

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  5. Contact Information:

    • If you need help resolving technical glitches, you can email us at [email protected].

    • For general information about the Madrid Protocol, please contact the Madrid Processing Unit at [email protected], or (571) 272-8910. Please include your telephone number in your email or voicemail so we can talk to you directly, if necessary. MPU is generally available Monday - Friday from 8:30 a.m. until 5:00 p.m. Eastern Time, except holidays, and will respond to your inquiry at the earliest opportunity.

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INTERNATIONAL REGISTRATION IDENTIFICATION SECTION

 


*INTERNATIONAL REGISTRATION NUMBER
Enter the 
one international registration Number as the basis for this subsequent designation.

Shape1

WARNING: If your entered international registration number is not accepted, but you recently received notification with this number from the International Bureau, the USPTO may not yet have received the same notification. The USPTO database must contain the number for this form to work, and the USPTO may receive the notification up to two weeks after receipt by the applicant/owner/representative.



Shape2 International Registration: 

NOTE: To verify that this is the correct international registration, please use the link above to review the international registration information.

1.  Do joint applicants own the mark?Shape3  Yes Shape4  No
If the answer is Yes, select the number of owners                                                                                                                                                                                                                                                                                                                                                              
Shape5

 

2.  How many classes are in your international registration?
Select the number of classes                                                                                                                                                                                                                                                                                                                                                              
Shape6

 

3.  Do you want to limit the goods and/or services listed within the international registration for purposes of this subsequent designation?
Note: To delete in this subsequent designation either (1) specific goods or services within a class; or (2) an entire class, as currently appears in the international registration, you must complete a limitation for the appropriate class(es).
Shape7  Yes Shape8  No
If 
YES, do you want to limit for ALL countries in the same way?Shape9  Yes Shape10 No

4.  In what country (or countries) and/or jurisdiction(s) do you want to extend protection through this subsequent designation?
WARNING: You must select all appropriate designated countries prior to attempting any fee payment.


Shape11    Select ALL countries listed below.

Shape12

Afghanistan

AF

Shape13

African Intellectual Property Organization (OAPI)

OA

Shape14

Albania

AL

Shape15

Algeria

DZ

Shape16

Antigua and Barbuda

AG

Shape17

Armenia

AM

Shape18

Australia

AU

Shape19

Austria

AT

Shape20

Azerbaijan

AZ

Shape21

Bahrain

BH

Shape22

Belarus

BY

Shape23

Benelux

BX

Shape24

Bhutan

BT

Shape25

Bosnia and Herzegovina

BA

Shape26

Botswana

BW

Shape27

Brazil

BR

Shape28

Brunei Darussalam

BN

Shape29

Bulgaria

BG

Shape30

Cambodia

KH

Shape31

Canada

CA

Shape32

Caribbean Netherlands (BES Islands)

BQ

Shape33

China

CN

Shape34

Colombia

CO

Shape35

Croatia

HR

Shape36

Cuba

CU

Shape37

Curacao

CW

Shape38

Cyprus

CY

Shape39

Czech Republic

CZ

Shape40

Democratic People's Republic of Korea (North Korea)

KP

Shape41

Denmark

DK

Shape42

Egypt

EG

Shape43

Estonia

EE

Shape44

Eswatini

SZ

Shape45

European Union (EUIPO) *

EM

 

Please select second language
Shape46

 

Shape47

Finland

FI

Shape48

France

FR



Shape49

Gambia

GM

Shape50

Georgia

GE

Shape51

Germany

DE

Shape52

Ghana

GH

Shape53

Greece

GR

Shape54

Guernsey

GG

Shape55

Hungary

HU

Shape56

Iceland

IS

Shape57

India

IN

Shape58

Indonesia

ID

Shape59

Iran (Islamic Republic of)

IR

Shape60

Ireland

IE

Shape61

Israel

IL

Shape62

Italy

IT

Shape63

Japan

JP

Shape64

Kazakhstan

KZ

Shape65

Kenya

KE

Shape66

Kyrgyzstan

KG

Shape67

Laos

LA

Shape68

Latvia

LV

Shape69

Lesotho

LS

Shape70

Liberia

LR

Shape71

Liechtenstein

LI

Shape72

Lithuania

LT

Shape73

Macedonia, The Former Yugoslav Republic of

MK

Shape74

Madagascar

MG

Shape75

Malawi

MW

Shape76

Malaysia

MY

Shape77

Mexico

MX

Shape78

Moldova, Republic of

MD

Shape79

Monaco

MC

Shape80

Mongolia

MN

Shape81

Montenegro

ME

Shape82

Morocco

MA

Shape83

Mozambique

MZ

Shape84

Namibia

NA

Shape85

New Zealand

NZ



Shape86

Norway

NO

Shape87

Oman

OM

Shape88

Pakistan

PK

Shape89

Philippines

PH

Shape90

Poland

PL

Shape91

Portugal

PT

Shape92

Republic of Korea (South Korea)

KR

Shape93

Romania

RO

Shape94

Russian Federation

RU

Shape95

Rwanda

RW

Shape96

Samoa

WS

Shape97

San Marino

SM

Shape98

Sao Tome and Principe

ST

Shape99

Serbia

RS

Shape100

Sierra Leone

SL

Shape101

Singapore

SG

Shape102

Sint Maarten

SX

Shape103

Slovakia

SK

Shape104

Slovenia

SI

Shape105

Spain

ES

Shape106

Sudan

SD

Shape107

Sweden

SE

Shape108

Switzerland

CH

Shape109

Syria

SY

Shape110

Tajikistan

TJ

Shape111

Thailand

TH

Shape112

Trinidad and Tobago

TT

Shape113

Tunisia

TN

Shape114

Turkey

TR

Shape115

Turkmenistan

TM

Shape116

Ukraine

UA

Shape117

United Kingdom

GB

Shape118

Uzbekistan

UZ

Shape119

Vietnam

VN

Shape120

Zambia

ZM

Shape121

Zimbabwe

ZW

 

 

 











*

NOTE: If designating the European Union (EU), you must select one EU entry that lists the specific language being designated as the "second" language for communication with the EU. Also, if you wish to make claims of seniority relative to your EU designation, you can now file these electronically using this form. If you choose not to file electronically, you must use WIPO's official forms to file on paper both the application for international registration WIPO Form MM2 and the claim of seniority as to the EU designation WIPO Form MM17.





5.   If designating the European Union, do you wish to claim seniority?Shape122  Yes Shape123  No

6.   Are you paying your international registration fees directly to WIPO? WIPO accepts payment by credit card, by account at WIPO's International Bureau, and by bank transfer.Shape124  Yes Shape125  No
If NO, you will be instructed how to make your payment directly to the USPTO through TEAS at the end of the form.
If YES, have you already paid the international registration fees to WIPO?
Shape126  Yes Shape127  No



7.  Do you need to enter an additional statement? (E.g.: Translation, Transliteration, Disclaimer, and/or Verbal Element)Shape128  Yes Shape129 No

DATE OF EFFECT OF THE SUBSEQUENT DESIGNATION

* Select ONE of the following three choices. The subsequent designation is to take effect:
Shape130    as of the date of receipt of the subsequent designation form at the United States Patent and Trademark Office.

Shape131    immediately after the renewal of the international registration used as the basis for this subsequent designation.

Shape132    immediately after the recording in the International Register of the following change concerning the international registration:

    Changes concerning the international registration:

    
Shape133



HOLDER OF THE INTERNATIONAL REGISTRATION SECTION  For Holder #1

*Holder Name:

Shape134
[If an individual, use following format: Last Name, First Name, Middle Initial/Name]

*  Street Address:

Shape135

Internal Address:

Shape136

*  City:

Shape137

* State
(Required for U.S. Addresses):

Shape138    If not listed, please specify here: Shape139

*  Country/Region/Jurisdiction:

                                                                                                                                                                                                                                                              Shape140    If not listed, please specify here: Shape141

* Zip/Postal Code
(Required for U.S. Addresses):

Shape142   



HOLDER ENTITY SECTION  For Holder #1

*Select appropriate entity type.
NOTE: If your entity type is not one of the options displayed directly below, you must click on "Other", and then select the appropriate entry from the relevant pull-down box. Your entity designation must match what appears in the USPTO database.

Shape143  Individual


Shape144  Corporation


Shape145  Partnership
Shape146  Limited Partnership
Shape147  Limited Liability Company
Shape148  Joint Venture
Shape149  Sole Proprietorship
Shape150  Trust
Shape151  Estate


Shape152  Other


HOLDER OF THE INTERNATIONAL REGISTRATION SECTION  For Holder #2

*Holder Name:

Shape153
[If an individual, use following format: Last Name, First Name, Middle Initial/Name]

*  Street Address:

Shape154

Internal Address:

Shape155

*  City:

Shape156

* State
(Required for U.S. Addresses):

                                                                      Shape157    If not listed, please specify here: Shape158

*  Country/Region/Jurisdiction:

                                                                                                                                                                                                                                                              Shape159    If not listed, please specify here: Shape160

* Zip/Postal Code
(Required for U.S. Addresses):

Shape161   

HOLDER ENTITY SECTION  For Holder #2

*Select appropriate entity type.
NOTE: If your entity type is not one of the options displayed directly below, you must click on "Other", and then select the appropriate entry from the relevant pull-down box. Your entity designation must match what appears in the USPTO database.

Shape162  Individual


Shape163  Corporation


Shape164  Partnership
Shape165  Limited Partnership
Shape166  Limited Liability Company
Shape167  Joint Venture
Shape168  Sole Proprietorship
Shape169  Trust
Shape170  Estate


Shape171  Other





ENTITLEMENT TO FILE SECTION  For Holder #1

*Only one of the following statements can be selected (even if more than one is factually correct).Shape172  The holder is a national of the United States.
Shape173  The holder has a domicile in the United States.
Shape174  The holder has a real and effective commercial establishment in the United States.  



ENTITLEMENT TO FILE SECTION  For Holder #2

*Only one of the following statements can be selected (even if more than one is factually correct).Shape175  The holder is a national of the United States.
Shape176  The holder has a domicile in the United States.
Shape177  The holder has a real and effective commercial establishment in the United States.  


NOTE:  Because the address listed for the holder in "Holder of the International Registration Section" is NOT in the United States, you must provide a U.S. address of either 1) the holder's domicile; or 2) its real and effective commercial establishment:



*Street Address:

Shape178

  Internal Address:

Shape179





*City:

Shape180





*State:

Shape181     






*Country:

United States     





*Zip/Postal Code:

Shape182







ADDITIONAL STATEMENTS

Shape183

Translation of the mark:
(As may be required by certain designated Contracting Parties, provide the translation into English and/or French and/or Spanish, specifying the language for each translation)

Enter Translation of the mark:
Shape184

Shape185

Check here if the words contained in the mark have no meaning and therefore cannot be translated.


Shape186

Transliteration of the mark:

Enter Transliteration of the mark:
Shape187

Shape188

Check here if the words in the mark cannot be transliterated.


Shape189

Verbal element contained within the mark that is not in standard characters:

Enter Verbal element contained within the mark that is not in standard characters:
Shape190

Shape191

The applicant disclaims protection for the following  element(s) of the mark:

Enter element(s) of the mark being disclaimed:
Shape192













GOODS / SERVICES SECTION 

All goods and/or services in the international registration will be extended to all Contracting Parties designated in this subsequent designation.

Contracting Party(ies)

  Class Code

 Goods / Services





NOTE: The class code and the description of goods and/or services for this subsequent designation will be identical to the data within the current international registration.



FEE SECTION

Subsequent Designation Fees and USPTO Transmittal Fee

The calculation of the subsequent designation fees can be determined from the WIPO fee calculator*. Total fees also include a set USPTO transmittal fee.

NOTE: Both the subsequent designation fees and the USPTO transmittal fee must be fully paid at the time of filing this subsequent designation, through the Pay/Submit process accessed after successful validation of this form.

WARNING: You must select all appropriate designated countries prior to attempting any fee payment.

*NOTE: To calculate fees correctly through the WIPO fee calculator page, you must (1) select the latest date (but not a future date) from the "For date:" pull-down menu; and (2) select "United States of America" from the "Country of Origin" pull-down menu.

Number of Classes

Shape193

Note: The class number is based on the number of classes actually being extended in the subsequent designation.

Subsequent Designation fees

Shape194

For information on this calculation, see WIPO fee calculator*.  Conversion from Swiss francs to U.S. dollars was based on the exchange rate of 1.1005943.

USPTO Transmittal Fee

Shape195

USPTO Transmittal Fee

Total Amount

Shape196

=Subsequent Designation Fees + USPTO Transmittal Fee

SIGNATURE

  i  

There is no requirement that this form be signed.











VALIDATION SECTION

STEP 1

Review the subsequent designation data, available below in two different formats, by clicking on either of the links.  Use the print function within your browser to print these pages for your own records.

 

STEP 2:

If any of the information is incorrect, click on the "< Previous" button at the bottom of this page to return to the form to make the necessary changes. Do not use your browser's "Back" or "Forward" buttons.

 

STEP 3:

If there are no errors and you are ready to file this form electronically, enter the email address for acknowledgement.  Once you submit the form, we will send an electronic acknowledgement of receipt to the email address entered below.  If you would like the acknowledgement sent to an additional address(es), please enter those address(es), separated by commas.

 

 

* Email for acknowledgment:

Shape197

* Confirm Email address:

Shape198

(Entries must match exactly, including case)



 

STEP 4:

Read and check the following:

Once you submit this subsequent designation, we will not cancel the filing or refund the USPTO transmittal fee.  The USPTO transmittal fee is a processing fee, which will not be refunded regardless of the future disposition of the subsequent designation.

Shape199  *If you have read and understand the above notice, please check the box before you click on the "Pay/Submit" button.

 

STEP 5:

To save the application, click on the "Save Form" button at the bottom of this page.

 

STEP 6:

To forward the application to another party for review prior to submission, click on the "Send for Review" button at the bottom of this page.

 

STEP 7:

If you are ready to file electronically, click on the "Pay/Submit" button at the bottom of this page.

NOTE:  If a fee payment is required, screens for entering payment information will come up after you have clicked on the "Pay/Submit" button.  After you successfully enter your payment information, your submission will be completed. Within 24 hours of completing your submission, you will receive an email acknowledgment of receipt.





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A Federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure to comply with an information collection subject to the requirements of the Paperwork Reduction Act of 1995, unless the information collection has a valid OMB Control Number. The OMB Control Number for this information collection is 0651-0051. Public burden for this form is estimated to average 75 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the information collection. Send comments regarding this burden estimate or any other aspect of this information collection, including suggestions for reducing this burden to the Office of the Chief Administrative Officer, United States Patent and Trademark Office, P.O. Box 1450, Alexandria, VA 22313-1450 or email [email protected].



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



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AuthorJohnson, Jo Ann
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File Created2022-05-15

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