Form PTO-1594 Recordation Form Cover Sheet - Trademarks Only

Form PTO-1594 (Rev. 6-18)
OMB Collection 0651-0027 (exp. XX/XX/XXXX)
Under the Paperwork Reduction Act of 1995, no persons are required to respond
to a collection of information unless it displays a valid OMB control number.

U.S. DEPARTMENT OF COMMERCE
United States Patent and Trademark Office

RECORDATION FORM COVER SHEET

TRADEMARKS ONLY
To the Director of the U. S. Patent and Trademark Office: Please record the attached documents or the new address(es) below.

2. Name and address of receiving party(ies)

1. Name of conveying party(ies):

Additional names, addresses, or citizenship attached?

Yes
No

Name:
Individual(s)

Association

Street Address:

Partnership

Limited Partnership

City:

Corporation- State:

State:

Other

Zip:

Country:

Citizenship (see guidelines)

Individual(s) Citizenship

Additional names of conveying parties attached?

Yes

No

3. Nature of conveyance/Execution Date(s) :

Association

Citizenship

Partnership

Citizenship

Limited Partnership

Execution Date(s)

Citizenship

Corporation Citizenship

Assignment

Merger

Security Agreement

Change of Name

Other

Other
Citizenship
If assignee is not domiciled in the United States, a domestic
Yes
No
representative designation is attached:
(Designations must be a separate document from assignment)

4. Application number(s) or registration number(s) and identification or description of the Trademark.
Text
B. Trademark Registration No.(s)
A. Trademark Application No.(s)
Additional sheet(s) attached?

Yes

C. Identification or Description of Trademark(s) (and Filing Date if Application or Registration Number is unknown):

5. Name & address of party to whom correspondence
concerning document should be mailed:
Name:

6. Total number of applications and
registrations involved:

Internal Address:

7. Total fee (37 CFR 2.6(b)(6) & 3.41)

$

Authorized to be charged to deposit account

Street Address:

Enclosed
8. Payment Information:

City:
Zip:

State:
Phone Number:

Deposit Account Number

Docket Number:

Authorized User Name

Email Address:
9. Signature:
Signature
Name of Person Signing

Date
Total number of pages including cover
sheet, attachments, and document:

Documents to be recorded (including cover sheet) should be faxed to (571) 273-0140, or mailed to:
Mail Stop Assignment Recordation Branch, Director of the USPTO, P.O. Box 1450, Alexandria, VA 22313-1450

No

Guidelines for Completing Trademarks Cover Sheets (PTO-1594)
Cover Sheet information must be submitted with each document to be recorded. If the document to be recorded
concerns both patents and trademarks, separate patent and trademark cover sheets, including any attached pages for
continuing information, must accompany the document. All pages of the cover sheet should be numbered consecutively for
example, if both a patent and trademark cover sheet is used, and information is continued on one additional page for both
patents and trademarks, the pages of the cover sheet would be numbered from 1 to 4.
Item 1. Name of Conveying Party(ies).
Enter the full name of the party(ies) conveying the interest. If there is more than one conveying party, enter a check
mark in the "Yes" box to indicate that additional information is attached. The name of the second and any subsequent
conveying party(ies) should be placed on an attached page clearly identified as a continuation of the information in Item 1.
Enter a check mark in the "No" box, if no information is contained on an attached page.
Item 2. Name, Address, Legal Entity Type, and Citizenship of Assignee.
Enter the name and complete address of the first party receiving the interest. If there is more than one receiving
party,check the "Yes" box to indicate that additional information is attached and write the wording “See additional sheet” on the
citizenship line. On a separate sheet, provide all of the necessary information about the other receiving parties, as explained
below. If the receiving party is an individual, check the “Individual” box and enter the citizenship of the receiving individual. If the
receiving party is a legal entity, i.e., corporation, association, limited partnership, etc., designate the legal entity and citizenship of
the receiving party by checking the appropriate box and filling in the citizenship information. If a box is not provided for the legal
entity, check the “Other” box and write the nature of the legal entity, e.g., limited liability company, trust, estate, etc., and its
citizenship. Information about the entity type and citizenship is mandatory.
The citizenship of a legal entity is as follows: for a corporation, it is the U.S. state (or foreign country) of incorporation; for
an association, it is the U.S. state (or foreign country) under which it is organized; for a partnership or joint venture, it is the U.S.
state (or foreign country) under which it is organized, etc. In addition, for a domestic partnership or domestic joint venture, the
cover sheet must include the names, legal entities, and national citizenship (or the state or country of organization) of all general
partners or active members that compose the domestic partnership or domestic joint venture. For a trust or estate, the same
information should be provided. If additional space is needed, check the "Yes" box to indicate that additional information is
attached, write the wording “See additional sheet” next to the appropriate entity designation, and provide the required information
on the additional sheet.
If the receiving party is not domiciled in the United States, a designation of domestic representative is encouraged. Check
the appropriate box to indicate whether or not a designation of domestic representative is attached. Check the "No" box if no
information is attached.
Item 3. Nature of Conveyance/Execution Date(s).
Enter the execution date(s) of the document. It is preferable to use the name of the month, or an abbreviation of that
name, to minimize confusion over dates. In addition, place a check mark in the appropriate box describing the nature of the
conveying document. If the "Other" box is checked, specify the nature of the conveyance. The "Other" box should be
checked if the conveying/receiving party is correcting a previously filed document.
Item 4. Application Number(s) or Registration Number(s).
Indicate the application number(s) including series code and serial number, and/or registration number(s) against
which the document is to be recorded. The identification of the trademark should be provided for all properties to avoid
recordation against the wrong property. A filing date should be provided only when the application or registration number is
unknown. Enter a check mark in the appropriate box: "Yes" or "No" if additional numbers appear on attached pages. Be
sure to identify numbers included on attached pages as the continuation of Item 4.
Item 5. Name and Address of Party to whom correspondence concerning document should be mailed.
Enter the name and full address of the party to whom correspondence is to be mailed.
Item 6. Total Applications and Trademarks Involved.
Enter the total number of applications and trademarks identified for recordation. Be sure to include all applications
and registrations identified on the cover sheet and on additional pages.
Item 7. Total Fee Enclosed.
Enter the total fee enclosed or authorized to be charged. A fee is required for each application and registration
against which the document is recorded.
Item 8. Payment Information.
Enter the deposit account number and authorized user name to authorize charges.
Item 9. Signature.
Enter the name of the person submitting the document. The submitter must sign and date the cover sheet. Enter the
total number of pages including the cover sheet, attachments, and document.
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 0651-0027. 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]. DO NOT SEND FEES OR COMPLETED FORMS TO THIS ADDRESS. SEND TO: Mail Stop Assignment Recordation
Branch, Director of the USPTO, P.O. Box 1450, Alexandria, VA 22313-1450.

Privacy Act Statement for Patent Assignment Recordation Form Cover Sheet
The United States Patent and Trademark Office (USPTO) collects this information under authority
of 37 CFR 3.11. The information in this system of records is used to manage requests to record
patent and trademark assignment documents. This may involve the collection of serial number,
filing date, title of invention, applicant’s or inventor’s address and addresses of applicant’s duly
appointed representatives. Failure to provide any part of the requested information may result in an
inability to process requests to record patent and trademark assignment documents.
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: to law
enforcement and investigation in the event that the system of records indicates a violation or
potential violation of law, whether civil, criminal, or regulatory in nature, to a Federal, state, local,
or international agency, in response to its request, to an agency, organization, or individual for the
purpose of performing audit or oversight operations as authorized by law, to non-federal personnel
under contract to the agency; to a court for adjudication and litigation; to the Department of Justice
for Freedom of Information Act (FOIA) assistance; to members of congress working on behalf of an
individual; to the Office of Personnel Management (OPM) for personnel research purposes; to
National Archives and Records Administration for inspection of records, and to share relevant
information contained in this system with the Office of Management and Budget (OMB), which
performs legislative coordination and clearance functions.. The applicable Privacy Act System of
Records Notice for this information is COMMERCE/PAT-TM-9, Patent Assignment Records:
Federal Register / Vol. 78, No. 61 / Friday, March 29, 2013 / Notices available at https://
www.govinfo.gov/content/pkg/FR-2013-03-29/pdf/2013-07378.pdf