Form PTO-2132 Application for Subsequent Designation (Individuals or Households)

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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
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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. Browser Requirement: IMPORTANT: To use this form successfully, please note the following requirements: You must have the cookies and javascript features of your browser enabled; Do NOT use your browser's "BACK" or "FORWARD" buttons at any time to navigate through any portion of this form. Always use the navigational tools provided specifically at the bottom of the form pages; and 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. 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. To navigate through each separate section of this form Do not use your browser's "Back" or "Forward" buttons. Instead, use the "< Previous" or "Next >" buttons at the bottom of each section of the form.  As you navigate through the sections, each section is validated before the next section is displayed. If there are any errors, you must fix them before proceeding to the next section. To save data already entered within a section, you must first click on "Next >" prior to using the "< Previous" button to return to any previous section. 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. Session Time Limit: You're required to log back in after 30 minutes of inactivity. This ensures the USPTO complies with mandatory federal information security standards and protects user information. After 25 minutes of inactivity, you will be prompted to continue your session. If you do not continue within 5 minutes, the session will end, you will be logged out of your USPTO.gov account, and you will lose any unsaved data in the form. Please have all of your information ready before you start.

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

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?  Yes   No
If the answer is Yes, select the number of owners                                                                                                                                                                                                                                                                                                                                                              

 

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

 

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).
 Yes   No
If YES, do you want to limit for ALL countries in the same way?  Yes  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.

   Select ALL countries listed below.

	Afghanistan	AF
	African Intellectual Property Organization (OAPI)	OA
	Albania	AL
	Algeria	DZ
	Antigua and Barbuda	AG
	Armenia	AM
	Australia	AU
	Austria	AT
	Azerbaijan	AZ
	Bahrain	BH
	Belarus	BY
	Benelux	BX
	Bhutan	BT
	Bosnia and Herzegovina	BA
	Botswana	BW
	Brazil	BR
	Brunei Darussalam	BN
	Bulgaria	BG
	Cambodia	KH
	Canada	CA
	Caribbean Netherlands (BES Islands)	BQ
	China	CN
	Colombia	CO
	Croatia	HR
	Cuba	CU
	Curacao	CW
	Cyprus	CY
	Czech Republic	CZ
	Democratic People's Republic of Korea (North Korea)	KP
	Denmark	DK
	Egypt	EG
	Estonia	EE
	Eswatini	SZ
	European Union (EUIPO) *	EM
	Please select second language
	Finland	FI
	France	FR

	Gambia	GM
	Georgia	GE
	Germany	DE
	Ghana	GH
	Greece	GR
	Guernsey	GG
	Hungary	HU
	Iceland	IS
	India	IN
	Indonesia	ID
	Iran (Islamic Republic of)	IR
	Ireland	IE
	Israel	IL
	Italy	IT
	Japan	JP
	Kazakhstan	KZ
	Kenya	KE
	Kyrgyzstan	KG
	Laos	LA
	Latvia	LV
	Lesotho	LS
	Liberia	LR
	Liechtenstein	LI
	Lithuania	LT
	Macedonia, The Former Yugoslav Republic of	MK
	Madagascar	MG
	Malawi	MW
	Malaysia	MY
	Mexico	MX
	Moldova, Republic of	MD
	Monaco	MC
	Mongolia	MN
	Montenegro	ME
	Morocco	MA
	Mozambique	MZ
	Namibia	NA
	New Zealand	NZ

	Norway	NO
	Oman	OM
	Pakistan	PK
	Philippines	PH
	Poland	PL
	Portugal	PT
	Republic of Korea (South Korea)	KR
	Romania	RO
	Russian Federation	RU
	Rwanda	RW
	Samoa	WS
	San Marino	SM
	Sao Tome and Principe	ST
	Serbia	RS
	Sierra Leone	SL
	Singapore	SG
	Sint Maarten	SX
	Slovakia	SK
	Slovenia	SI
	Spain	ES
	Sudan	SD
	Sweden	SE
	Switzerland	CH
	Syria	SY
	Tajikistan	TJ
	Thailand	TH
	Trinidad and Tobago	TT
	Tunisia	TN
	Turkey	TR
	Turkmenistan	TM
	Ukraine	UA
	United Kingdom	GB
	Uzbekistan	UZ
	Vietnam	VN
	Zambia	ZM
	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?  Yes   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.  Yes   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?  Yes   No

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

DATE OF EFFECT OF THE SUBSEQUENT DESIGNATION

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

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

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

    Changes concerning the international registration:

    

HOLDER OF THE INTERNATIONAL REGISTRATION SECTION  For Holder #1
*Holder Name:	[If an individual, use following format: Last Name, First Name, Middle Initial/Name]
*  Street Address:
Internal Address:
*  City:
* State (Required for U.S. Addresses):	If not listed, please specify here:
*  Country/Region/Jurisdiction:	If not listed, please specify here:
* Zip/Postal Code (Required for U.S. Addresses):
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.
Individual
Corporation
Partnership  Limited Partnership  Limited Liability Company  Joint Venture  Sole Proprietorship  Trust  Estate
Other
HOLDER OF THE INTERNATIONAL REGISTRATION SECTION  For Holder #2
*Holder Name:	[If an individual, use following format: Last Name, First Name, Middle Initial/Name]
*  Street Address:
Internal Address:
*  City:
* State (Required for U.S. Addresses):	If not listed, please specify here:
*  Country/Region/Jurisdiction:	If not listed, please specify here:
* Zip/Postal Code (Required for U.S. Addresses):
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.
Individual
Corporation
Partnership  Limited Partnership  Limited Liability Company  Joint Venture  Sole Proprietorship  Trust  Estate
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).  The holder is a national of the United States.
 The holder has a domicile in the United States.
 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).  The holder is a national of the United States.
 The holder has a domicile in the United States.
 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:
Internal Address:
*City:
*State:
*Country:	United States
*Zip/Postal Code:

ADDITIONAL STATEMENTS
	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:
	Check here if the words contained in the mark have no meaning and therefore cannot be translated.
	Transliteration of the mark:	Enter Transliteration of the mark:
	Check here if the words in the mark cannot be transliterated.
	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:
	The applicant disclaims protection for the following  element(s) of the mark:	Enter element(s) of the mark being disclaimed:

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

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

Subsequent Designation fees

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

USPTO Transmittal Fee

Total Amount

=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:
* Confirm Email address:
(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.

 *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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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