TRADEMARK REGISTRATION CLIENT INTAKE FORM
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Residential Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Company Name (If Any)
Industry (If any)
Business Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Business Structure (if applicable)
Please Select
Sole-Owned LLC
Multi-Member LLC
Partnership
C-Corp
S-Corp
B-Corp
NFP Organization or Ministry
Website Address:
What time zone you are in?
TRADEMARK INFORMATION
Federal Trademark Registration Request
*
Please Select
Brand Name
Brand Logo
Brand Slogan
Brand Design (Trade Dress)
Requested Trademark
*
Do you need us to file more than one federal trademark application?
*
Please Select
Yes
No
I need help with this decision
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
If you are requesting a logo trademark or a stylized name trademark, please provide a JPG or JPEG version of it here.
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Is color an important feature of your trademark? [Special Note: If we include one or more specific colors in your federal trademark application, the color(s) cannot be changed.]
*
Yes, the color(s) is important. I understand I cannot change the color(s) listed in my trademark application
No, the color(s) of my brand is not an important feature of my brand
When do you want to start the federal trademark registration process?
*
Please Select
Immediately (5 days or less) - RUSH FEE $250
2 weeks or less
2-4 weeks
4-8 weeks
Geographic area of brand usage
*
Please Select
USA Only
USA + International
Please describe your products and services. If your products and services fall within more than one international trademark class, an additional USPTO filing fee(s) will apply.
*
Please select one of the following USPTO trademark application options
IN USE [1(a)]: For marks already in use in U.S. commerce.
INTENT TO USE [1(b)]: For marks intended for future use in U.S. commerce.
FOREIGN APPLICATION [44(d)]: For marks with a trademark application filed in another country within months of your U.S. application, for the same goods/services from your country of origin.
FOREIGN APPLICATION [44(e)]: For marks with a foreign registration of the same mark for the same goods/services from your country of origin.
INTERNATIONAL [(66(a)]: For marks with a U.S. trademark application or registration and you want to use the Madrid Protocol to apply for registrations in other countries.
Please provide the name of the person or entity who will own the trademark
*
If there will be more than one owner of the trademark, please provide the co-owner(s) name, email address, mailing address, and phone number.
When was the first date you used 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.)
ATTORNEY ENGAGEMENT AGREEMENT
Agreed to and Accepted By:
New Client Signature
Signature Date
-
Month
-
Day
Year
Date
Agreed to and Accepted By:
Schedule Your Trademark Strategy Consultation Call
*
Brillionaire® Trademark Package
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Enter Amount: Full Pay Option ($2495 due now) or Payment Plan Option ($931.67 deposit due now + 2 additional payments of $931.67 x 2 months). The fee amount includes the USPTO Filing Fee for 1 TM Class (up to $350). Legal services begin as soon as the initial payment is received. However, the filing is submitted upon receipt of full payment. The balance for any payment plans are billed separately.
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