TRADEMARK

I. Contact Information

• Applicant Name: [Your Name]

• Company Name: [Your Company Name]

• Address: [Your Company Address]

• Email: [Your Company Email]

• Phone Number: [Your Company Number]

II. Trademark Details

Trademark Name: [Trademark Name]

Trademark Description: [Brief Description]

Goods/Services: [List of Goods/Services]

Date of First Use: [Date (MM/DD/YYYY)]

Type of Trademark:

• [Word Mark]

• [Design Mark]

• [Combined Mark]

III. Disclaimer

Disclaimer Text: [Optional Disclaimer]

IV. Specimen Information

Specimen Description: [Description of Commerce Mark Use]

Specimen File: [Attach File]

V. Declaration

I, [Your Name], hereby declare that I am the owner of the trademark sought to be registered and that the information provided herein is true and accurate to the best of my knowledge.

VI. Table of Key Dates

Event	Date
Application Date	[MM/DD/YYYY]
Examination Date	[MM/DD/YYYY]
Publication Date	[MM/DD/YYYY]
Registration Date	[MM/DD/YYYY]

Signature

[Your Name]

[Your Company Name]

Date: [MM/DD/YYYY]