TRADEMARK CLIENT INTAKE FORM

Name

First NameMiddle NameLast Name

Email

example@example.com

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

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 type of trademark do you want to federally register?

Enter the name, phrase, or exact wording of you trademark.

Do you need our office to handle the federal trademark prosecution for more than one brand asset?

If you need our office to handle the federal trademark prosecution for more than one brand asset, please list the additional request(s) 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.)

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

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 (a trademark specimen) to complete the federal trademark proceedings. If you have not launched your brand, please select the option that you will commit to in order to proceed with the federal prosecution proceeding.

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?

Other

SIGNATURE TRADEMARK PACKAGE: Fee Payment Selection - Fee includes the $350 USPT filing fee for one (1) trademark class

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. The flat fee only covers consultation, filign strategy, filing fee for 1 trademark class, unlimited administrative (non-substantive) responses, correspondence with federal attorneys and USPTO updates as actions take place. Additional services are subject to additional fees. 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

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: