TRADEMARK Registration Client Intake Form

Name

First NameMiddle NameLast Name

Email

example@example.com

Phone Number

Please enter a valid phone number.

Residential Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Business Name (If Any)

Industry (If any)

Business Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

This information helps us provide tailored, timely, and legally precise trademark representation aligned with your business structure and brand reach

Business Structure (if applicable)

Official Business Website (if available):

What time zone you are in?

What type of trademark do you want to federally register?*

Enter the name, phrase, or exact wording you wish to trademark.*

Do you need us to file more than one federal trademark application?*

If you need our legal services for more than one federal trademark application, please list your other brand names, logos, or slogans in this section

Upload your logo or stylized brand name (JPG/JPEG recommended)"

This version will be submitted with your USPTO application, so please ensure it is final.

Are specific colors essential to the legal identity of your logo? (Colors cannot be altered post-filing.)

Yes, the color(s) is important. I understand I cannot change the color(s) listed in my trademark applicationNo, the color(s) of my brand is not an important feature of my brand

When would you like our legal team to initiate your federal trademark filing?*

Geographic area of brand usage*

Describe your core offerings clearly. If your brand covers multiple industries or product types, note each separately so we can prepare your application accurately.*

Please select one of the following USPTO trademark application options

IN USE [1(a)]: I am using my mark in U.S. commerce.INTENT TO USE [1(b)]: I am not using my mark in U.S. commerce at this time.FOREIGN APPLICATION [44(d)]: I have a trademark application pending or a USA registered trademark.FOREIGN APPLICATION [44(e)]: I have a trademark registered in another state and I want to register my trademark in the USA for the same goods and services.INTERNATIONAL [(66(a)]: I want to obtain a trademark registration in more than one country at the same time

Who will legally own the trademark? (Full legal name of individual or entity)*

Additional Owner(s) Information (Full names, email addresses, addresses, phone numbers)

Please provide ALL of the information requested as it must be submitted to the USPTO.

If you are using your brand now, when was the MM/DD/YYYY you began using the trademark to sell or advertise your products or services?

(If you have not yet begun "use" of your trademark please put N/A for not applicable.)

You must provide brand usage evidence to complete the federal trademark proceedings. If you have launched your brand, we usually provide website evidence that complies with USPTO requirements (see image below). If you have not launched your brand, please select the option that you acknowledge you will commit to in order to proceed with the process.*

I will provide a webpage link to my USPTO acceptable specimen (brand usage evidence) within 15 days of completing this form.I will provide a webpage link to my USPTO acceptable specimen (brand usage evidence) within 30 days of completing this formI will NOT will provide a webpage link to my (brand usage evidence) within 30 days of completing this form. If I promise to provide this information within 30 days, I will be granted a 15 day extension. If the information is not provided within 45 days from the date securing attorney service, I give your office permission to proceed with filing an intent-to-use 1(b) application (based on the information I have provided by this timeframe) and I acknowledge that I must pay additional fees for this option 8-12 months from the filing date.

If you like to provide any additional information, please write a brief statement in the section below.

Would you like to save money and expand the protection of your brand portfolio now?

Additional trademark class ($850, includes $350 USPTO federal fee)(if not selected now, a new USPTO federal filing would be required that would be assigned to a different USPTO Federal attorney)Trademark monitoring ($1200/yr per trademark, includes enforcement strategy call)Additional trademark special package offer, if selected now ($2500, includes full strategy and $350 USPTO federal fee)I'd like a custom quote for multiple classes or registrationsOther

Fee Payment Selection*

Full Payment - $3,500 (includes federal filing fee)Payment Plan: $1850 Deposit + Balance w/in 30 days - (includes federal filing fee)Special Payment Plan: $1,235 Deposit + Balance w/in 45 days - (includes federal filing fee)Financing via Afterpay or Klarna

You may make your payment using this link (enter amount, select my name, invoice is your LastName2026).

Payment Link: http://www.kentlaw.iit.edu/clientpayments

*You may also use the form credit card form below and we will complete the payment and you will receive a receipt via email.

ACKNOWLEGMENT: This invoice covers only the legal services (and one federal filing fee) identified above and in the Attorney Engagement Agreement. Payment plans include an additional administrative fee. Additional services are subject to additional fees and may require a separate engagement agreement. There are no refunds for legal services completed. Any balance not paid within forty-five (45) days of the invoice date will incur a $50.00 late fee, with additional late fees of $50.00 applied monthly thereafter until paid. If the online payment link is not used to submit a required monthly payment by the thirty (30) day deadline, Client will complete a payment authorization form authorizing the Law Firm to charge the authorized payment method on file on the next business day. Failure to timely pay may result in suspension of work or withdrawal from representation consistent with the engagement terms.

New Client Signature

Signature Date

Date

Brillionaire® Trademark Package

USDSTANDARD FULL FEE: $3,500 or PAYMENT PLAN: $1850 Deposit w/ $1850balance due in 30 days. This Invoice covers only the legal services identified above. Payment plans include an additional administrative fee. Additional services are subject to additional fees and may require a separate engagement agreement. There are no refunds for legal services completed. Any balance not paid within thirty (30) days of the invoice date will incur a $50.00 late fee, with additional late fees of $25.00 applied monthly thereafter until paid. If the online payment link is not used to submit a required monthly payment by the thirty (30) day deadline, Client authorizes the Law Firm to automatically charge the authorized payment method on file on the next business day. Failure to timely pay may result in suspension of work or withdrawal from representation consistent with the engagement terms.

Credit Card

TRADEMARK PROTECTION INTAKE FORM

TRADEMARK INFORMATION

TRADEMARK SPECIMEN REQUIREMENT

Add-On Trademark Services

Agreed to and Accepted By:

ATTORNEY ENGAGEMENT AGREEMENT

Agreed to and Accepted By:

Credit Card