Form PTO-2131 Application for International Registration

Madrid Protocol

0051 PTO-2131 TM-TEAS-Application-for-International-Registration

Application for International Registration (Private Sector)

OMB: 0651-0051

Document [docx]
Download: docx | pdf

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PTO-2131
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 International Registration


SELECTION OF FORM TYPE FOR APPLICATION FOR INTERNATIONAL REGISTRATION

What type of form do you wish to use?

PRE-POPULATED FORM
(Use for 
one U.S. basic application serial/registration number; narrowing of goods/services and/or substitute color drawing are permissible data change within this form.)
Enter the 
one U.S. basic application serial number or registration number as the basis of this international application.

Shape1
Enter the number with NO punctuation or other symbols included.
WARNING: You CANNOT use the pre-populated form if the basic registration is classified using the old US Classification system. You must use the free-text form instead.

 

OR

FREE-TEXT FORM
(Use for multiple U.S. 
basic application serial/registration numbers and/or for cases that do not yet appear in TSDR and/or if changing data other than only narrowing goods/services and/or substituting color drawing.)
Enter the U.S. 
basic application serial number(s) or registration number(s) as the basis of this international application. Separate multiple numbers with a comma.

Shape2
Enter the number with NO punctuation or other symbols included.

 

The pre-populated form will automatically display the exact information that is already in the USPTO database for one specific U.S. basic application serial number or registration number. If you do not change any data fields, then the pre-populated form will directly submit information that must be certified to the International Bureau (IB) of the World Intellectual Property Organization (WIPO), without independent review of this data at the USPTO. Alternatively, this form may be used where certain data fields can be changed (e.g., either narrowing the scope of the identification of goods and/or services in the U.S. basic application or registration, and/or substituting a color drawing of the mark, where the original mark is shown in the USPTO database as a black-and-white image). However, if any data field is changed, an independent review of this data by the USPTO's Madrid Processing Unit must occur prior to submission as certified to the IB.

The free-text form must be used if: (1) the application for international registration is based on more than one U.S. basic application serial number or registration number; (2) data is being changed in any way other than only narrowing the scope of the identification of goods and/or services in the U.S. basic application or registration, and/or substituting a color drawing of the mark, where the original mark is shown in the USPTO database as a black-and-white image; or (3) the U.S. basic application used as the basis is not yet loaded into the USPTO database at the time of filing, e.g., the international application is being filed immediately after a U.S. basic application was filed. Information on this form is not automatically certified, and will not be submitted electronically directly to the IB. Instead, the form will be routed to the USPTO's Madrid Processing Unit for review, for subsequent certification, if appropriate.


OWNER: 




MARK:






Answer each question below to create an international application form showing only sections relevant to your specific filing, then click the "Next" button.
WARNING: Changing any of the pre-populated data that must be certified to the International Bureau (IB) of the World Intellectual Property Organization (WIPO) will preclude automatic certification and delivery by the USPTO, and will require independent review of this data at the USPTO prior to submission as certified to the IB.

 

1.   Do you want to substitute a color mark image for the black-and-white mark image currently in the U.S. basic application or registration that is the basis of this international application?Shape3  Yes Shape4  No




 

2.   Do you want to limit and/or exclude the goods and/or services listed in the U.S. basic application or registration for purposes of this international application?Shape5  Yes Shape6  No
If 
YES, do you want to limit for ALL countries in the same way?Shape7  Yes Shape8  No

 

3.   In what country (or countries) and/or jurisdiction(s) do you want to extend protection through this international application?

Shape9    Select ALL countries listed below.

Shape10

Afghanistan

AF

Shape11

African Intellectual Property Organization (OAPI)

OA

Shape12

Albania

AL

Shape13

Algeria

DZ

Shape14

Antigua and Barbuda

AG

Shape15

Armenia

AM

Shape16

Australia

AU

Shape17

Austria

AT

Shape18

Azerbaijan

AZ

Shape19

Bahrain

BH

Shape20

Belarus

BY

Shape21

Benelux

BX

Shape22

Bhutan

BT

Shape23

Bosnia and Herzegovina

BA

Shape24

Botswana

BW

Shape25

Brazil

BR

Shape26

Brunei Darussalam

BN

Shape27

Bulgaria

BG

Shape28

Cambodia

KH

Shape29

Canada

CA

Shape30

Caribbean Netherlands (BES Islands)

BQ

Shape31

China

CN

Shape32

Colombia

CO

Shape33

Croatia

HR

Shape34

Cuba

CU

Shape35

Curacao

CW

Shape36

Cyprus

CY

Shape37

Czech Republic

CZ

Shape38

Democratic People's Republic of Korea (North Korea)

KP

Shape39

Denmark

DK

Shape40

Egypt

EG

Shape41

Estonia

EE

Shape42

Eswatini

SZ

Shape43

European Union (EUIPO) *

EM

 

Please select second language
          Shape44

 

Shape45

Finland

FI

Shape46

France

FR


Shape47

Gambia

GM

Shape48

Georgia

GE

Shape49

Germany

DE

Shape50

Ghana

GH

Shape51

Greece

GR

Shape52

Guernsey

GG

Shape53

Hungary

HU

Shape54

Iceland

IS

Shape55

India

IN

Shape56

Indonesia

ID

Shape57

Iran (Islamic Republic of)

IR

Shape58

Ireland

IE

Shape59

Israel

IL

Shape60

Italy

IT

Shape61

Japan

JP

Shape62

Kazakhstan

KZ

Shape63

Kenya

KE

Shape64

Kyrgyzstan

KG

Shape65

Laos

LA

Shape66

Latvia

LV

Shape67

Lesotho

LS

Shape68

Liberia

LR

Shape69

Liechtenstein

LI

Shape70

Lithuania

LT

Shape71

Macedonia, The Former Yugoslav Republic of

MK

Shape72

Madagascar

MG

Shape73

Malawi

MW

Shape74

Malaysia

MY

Shape75

Mexico

MX

Shape76

Moldova, Republic of

MD

Shape77

Monaco

MC

Shape78

Mongolia

MN

Shape79

Montenegro

ME

Shape80

Morocco

MA

Shape81

Mozambique

MZ

Shape82

Namibia

NA

Shape83

New Zealand

NZ


Shape84

Norway

NO

Shape85

Oman

OM

Shape86

Pakistan

PK

Shape87

Philippines

PH

Shape88

Poland

PL

Shape89

Portugal

PT

Shape90

Republic of Korea (South Korea)

KR

Shape91

Romania

RO

Shape92

Russian Federation

RU

Shape93

Rwanda

RW

Shape94

Samoa

WS

Shape95

San Marino

SM

Shape96

Sao Tome and Principe

ST

Shape97

Serbia

RS

Shape98

Sierra Leone

SL

Shape99

Singapore

SG

Shape100

Sint Maarten

SX

Shape101

Slovakia

SK

Shape102

Slovenia

SI

Shape103

Spain

ES

Shape104

Sudan

SD

Shape105

Sweden

SE

Shape106

Switzerland

CH

Shape107

Syria

SY

Shape108

Tajikistan

TJ

Shape109

Thailand

TH

Shape110

Trinidad and Tobago

TT

Shape111

Tunisia

TN

Shape112

Turkey

TR

Shape113

Turkmenistan

TM

Shape114

Ukraine

UA

Shape115

United Kingdom

GB

Shape116

Uzbekistan

UZ

Shape117

Vietnam

VN

Shape118

Zambia

ZM

Shape119

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.



 

4.   If designating the European Union, do you wish to claim seniority?Shape120  Yes Shape121  No

 

5.   Do you wish to claim priority based on the earlier filing(s)?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.   Is an attorney or representative handling the filing of this international application?Shape128 Yes Shape129 No


BASIC APPLICATION SECTION

Serial Number:

Filing Date:
 
(mm/dd/yyyy)

Registration Number:

Registration Date:
 
(mm/dd/yyyy)


Shape130

Shape131

Shape132


NOTE: "0000000" means no registration number exists.
"00/00/0000" means no filing date/registration date exists.


PRIORITY CLAIMED SECTION

* Country/Region/Jurisdiction of Earlier Filing

                                                                                                                                                                                                                                                                          Shape133

* Application/Serial Number of Earlier Filing

Shape134

* Date of Earlier Filing

Shape135
MM/DD/YYYY
NOTE: The International Bureau will disregard any claimed priority date that is more than six (6) months earlier than the date of the international registration, and will so inform the applicant and Office of origin.

Goods and/or Services Listed in Earlier Filing, for which Priority Claimed

NOTE: If country of earlier filing is the United States, click the "Retrieve GS" button, below, to populate Class and Goods/Services data automatically.

Otherwise, use the pull-down box to specify the number of classes you wish to add and click on the "Add Classes" button, below.


Number of Classes to be added

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          Shape136


 





Note: If you wish to file more than one claim of seniority, complete the information for the first claim of seniority, and then click on the "Add" button at the bottom of the seniority list page. Repeat, as necessary, to enter all seniority claims.

Member State of the European Union:

* Member State of the European Union :

                                              Shape137

Nature of the registration:

* Nature of Registration

      Shape138

Earlier Registered Mark Information:

* Registration Number

Shape139

Filing Date (mm/dd/yyyy)

Shape140

* Registration Date (mm/dd/yyyy)

Shape141

Priority Date (mm/dd/yyyy)

Shape142

Seniority Type:

* Seniority Type

      Shape143

Goods And Services for which the earlier mark is registered
(indicate these goods and services, grouped in the appropriate class(es)):

* Class Code

* Goods and/or Services

Delete Class


Number of Classes to be added

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           Shape144







 APPLICANT SECTION 

*Owner Name:

Shape145
[If an individual, use following format: Last Name, First Name, Middle Initial/Name]

*Street Address:

Shape146

Internal Address:

Shape147

*City:

Shape148

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

                                                                Shape149    If not listed, please specify here: Shape150

*Country/Region/Jurisdiction:

                                                                                                                                                                                                                                                        Shape151    If not listed, please specify here: Shape152

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

Shape153

Phone Number:

Shape154

Fax Number:

Shape155

*Email Address:

Shape156
NOTE:  Enter ONE email address only, not more than 60 characters in length. All communication with the applicant or its attorney/representative must be via email. While the application may list separate email addresses for the applicant and the applicant's attorney/representative, only one email address will be used for correspondence. If an email address is provided for an attorney/representative, that will be the email address used; otherwise, the applicant's email address will be used. The applicant must keep this email address current in the USPTO records. Also, the applicant is solely responsible for receipt of documents sent via email. If communication has been sent to the provided email address, the USPTO is not responsible for any email not received due to the applicant's security or anti-spam software, or any problems with the applicant's email system.

ENTITY SECTION 

Shape157  a tribally-chartered corporation formed under the laws of the San Pasqual Band of Mission Indians

State or Country/Region/Jurisdiction Where Organized   Shape158


ENTITLEMENT TO FILE SECTION 

*Only one of the following statements can be selected (even if more than one is factually correct).Shape159  The applicant is a national of the United States.
Shape160  The applicant has a domicile in the United States.
Shape161  The applicant has a real and effective commercial establishment in the United States.  


REPRESENTATIVE SECTION

 

WIPO's Common Regulations under the Madrid Protocol do not provide for any requirement as to professional qualification, nationality, residence or domicile, and appointment of a representative in the international application only empowers him/her to act before the International Bureau. If a partnership or firm composed of attorneys or agents is indicated in the application form as representative, only the partnership or firm itself will be recorded as representative.

NOTE: Please complete the fields below where data is missing, or change any data that is incorrect. Because of how data is currently stored in the USPTO database, we are unable to pre-populate all of the fields below, even though the data might already be in the USPTO record.

*Name:

Shape162
NOTE: You must limit your entry here to no more than 50 characters.

Firm  Name:

Shape163
NOTE: You must limit your entry here to no more than 50 characters.

*Street Address:

Shape164
NOTE: You must limit your entry here to no more than 50 characters.

Internal Address:

Shape165
NOTE: You must limit your entry here to no more than 50 characters.

*City:

Shape166
NOTE: You must limit your entry here to no more than 40 characters.

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

Shape167    If not listed, please specify here: Shape168
NOTE: You must limit your entry here to no more than 50 characters.

Country/Region/Jurisdiction:

                                                                                                                                                                                                                                             Shape169   

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

Shape170

Phone Number:

Shape171

Fax Number:

Shape172

*Email Address:

Shape173
NOTE:  Enter ONE email address only, not more than 60 characters in length. All communication with the applicant or its attorney/representative must be via email. While the application may list separate email addresses for the applicant and the applicant's attorney/representative, only one email address will be used for correspondence. If an email address is provided for an attorney/representative, that will be the email address used; otherwise, the applicant's email address will be used. The applicant must keep this email address current in the USPTO records. Also, the applicant is solely responsible for receipt of documents sent via email. If communication has been sent to the provided email address, the USPTO is not responsible for any email not received due to the applicant's security or anti-spam software, or any problems with the applicant's email system.
















 MARK SECTION 

Click on the 'Browse' button to select a JPG/JPEG image file from your local drive that shows a proper color reproduction of the mark.
NOTE:The file name excluding the image extension (e.g., .jpg) must not exceed 34 characters, or include commas.
                             

The following file is attached to the form. Select another file to replace it.

File Uploaded




NOTE: If you have uploaded a color image, but do not wish to proceed with that color image, you must return to the Wizard page and answer "No" to Question #1. When you return to the Mark section, your original image from the USPTO database will then be displayed.

Shape174

If a description of the mark appears in the basic application and/or registration, enter the same description here. If no description is in the basic application and/or registration, do not enter any description here.

Note: Do not enter any USPTO design search codes in your description of the mark.

WARNING: Although the presented image for the U.S. application may be in color, we possibly could not retrieve data for the description of the mark, including location of color(s). Therefore, if appropriate, you should enter this information, or the Madrid Processing Unit may reject your application.

Mark description:
Shape175

Shape176

Check here if you wish to claim color as a distinctive feature of the mark.

 

 



If color is claimed as a feature of the mark in the basic application and/or registration, you must claim color in the international application. Identify here the portions of the mark that are in color and the corresponding color for each. The entered color claim must be the same as in the basic application and/or registration.

The parts of the mark in color consist of:
Shape177

 



If claiming color as a distinctive feature of the mark list only the color(s) (e.g., red and blue):

The color(s) in the mark is/are:
Shape178

Shape179

Check here if the mark is a three-dimensional mark (such as product design or product packaging configuration / trade dress).

 

Shape180

Check here if the mark is a sound mark.

Shape181

Check here if the mark is a collective mark or certification mark.



 MARK SECTION 





Shape182

Check here if the mark consists of standard characters, without claim to any particular font, style, size or color.

 

Shape183

Check here if the mark is a collective mark or certification mark.



ADDITIONAL STATEMENTS

Shape184

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:
Shape185

Shape186

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


Shape187

Transliteration of the mark:

Enter Transliteration of the mark:
Shape188

Shape189

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


Shape190

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:
Shape191

Shape192

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

Enter element(s) of the mark being disclaimed:


GOODS / SERVICES SECTION 

Overall goods and/or services for which international registration is sought:
(as listed in the existing U.S. application or registration)



Bar services; Restaurant services; Restaurant and bar services

Contracting Party(ies)

  Class Code

 Goods / Services


European Union (EUIPO) EM


Bar services; Restaurant services; Restaurant and bar services

   Shape193  Check here if you wish to exclude this class  from your international application.


GOODS / SERVICES SECTION 

Overall goods and/or services for which international registration is sought:
(as listed in the existing U.S. application or registration)





To limit completely the goods and services for this class for all the contracting parties in the application click on the check box labeled 'Total Limitation" below. To narrow the entry for the contracting party(ies) listed below, click on the check box labeled Narrow and edit the existing listing of Goods or recitation of Services for which protection in this International Application is sought. The change will be the same for all countries, and cannot exceed the scope of the current identification of Goods or recitation of Services. If the change differs for various countries, you must return to the Wizard and change the answer to "No" for the second part of Question #3.

Contracting Party(ies)

  Class Code

 Goods / Services




Shape194  Select complete listing of goods/services for this class. (Not Limiting this class)
Shape195  Total Limitation for the complete listing of goods/services for this class.
Shape196  Narrow the listing of goods/services for this class: (Partial Limitation of this class)
       

For partial limitation, enter the modified goods/services here:
(enter complete listing of goods/services to be extended internationally to identified contracting party(ies)) :










FEE SECTION

International Registration Fees and USPTO Certification Fee

The international registration fees are based on the specific election of fees by the designated countries. The calculation of the international registration fees can be determined from the WIPO fee calculator*. Total fees also include a set USPTO certification fee based on the total number of classes in the international application, with each class only counting once, even if that class is claimed multiple times for different Contracting Party countries within this international application.

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

*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

Shape197

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

International Registration fees

Shape198

For information on this calculation, see WIPO fee calculator*.  Conversion from Swiss francs to U.S. dollars was based on the exchange rate of 1.0883761.

USPTO Certification Fee

Shape199

=USPTO Certification Fee x Number of Classes

Total Amount

Shape200

=International Registration Fees + USPTO Certification Fee

SIGNATURE

  i  

There is no requirement that this form be signed.




VALIDATION SECTION

STEP 1

Review the international application data, available below in various formats, by clicking on any 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 application form to make the necessary changes. Do not use your browser's "Back" or "Forward" buttons.
NOTE: If you are not satisfied with the USPTO-created image of your mark (accessed above):

  1. Return to the initial form selection page and select the free-text form option;

  2. In the Mark Information Section, follow the steps at Option 2, i.e., to attach your own JPG file.
    NOTE: The attached image must be identical to the mark in the U.S. basic application or registration; and

  3. If appropriate, check the first box below where the image has been attached, to claim that the mark consists of standard characters, without claim to any particular font, style, size or color.

 

STEP 3:

If there are no errors and you are ready to file this application electronically, enter the email address for acknowledgement.  Once you submit the application, 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:

Shape201

* Confirm Email address:

Shape202

(Entries must match exactly, including case)


 

STEP 4:

Read and check the following:

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

Shape203  *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 40 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 USPTO collects this information under authority of 35 U.S.C. 2(b)(2). The information you provide will be used to process your applications and submissions related to trademark registration. 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. The information 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: the public; certain foreign entities, professional organizations or associations, audit or oversight controls; law enforcement; non-federal personnel working for the agency; record and informational inquiries; coordinators of data breach response; litigation actions; Department of Justice; Office of Personnel Management; Congressional inquiries; the National Archives and Records Administration; and Office of Management and Budget. If you do not furnish the requested information, the U.S. Patent and Trademark Office may not be able to process and/or examine your submission, which may result in termination of proceedings or abandonment of the application for trademark registration. 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 Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorSmalls, Jonya
File Modified0000-00-00
File Created2022-05-15

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