Trademark Intake Form
Name of Applicant/Owner of the Mark
*
First Name
Last Name
Business Name
Signatory of Trademark Application
*
Title of Signatory
*
Owner, CEO, President, etc.
E-mail
*
example@example.com
Phone Number
*
Format: (000) 000-0000.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Is the mark a word mark or logo/design mark?
*
Please Select
Word mark
Logo/design mark
Word mark
What is your mark?
If the mark is a logo/design, upload a black and white image of the logo/design
Browse Files
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Description of the goods or services attached to the mark
*
Is the mark currently in use and being displayed on the goods/services?
*
Please Select
Yes currently in use
No, not currently in use but will be soon
If the mark is currently in use, enter the first date of use
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Do you know of any trademarks that are similar to this mark and which are used to sell similar goods or services? If so, explain.
*
Additional Questions/Comments
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