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Back to Forms for 'Trademarks'.






Mark:  ______________________________________________


Registration Number:  _________________________________


Class Number:  ______________________________________





State of:   __________________________________________

County of:  ________________________________________



________________________________________ (Name of Corporate Officer) being duly sworn, states that:  


1.  __________ (He or She) is the _____________________________ (Secretary) of ________________________________ (Corporation), a corporation duly organized  under the laws of the State of ______________, located and doing business at __________________________________________________________ (Address);


2.  __________ (He or She) believes that such corporation is the owner of Registration   Number _______________________________________________; 


3.  The mark described therein has been in continuous use in ____________________    (Interstate) commerce from __________ (Date) in connection with the following goods specified in the registration, namely, ________________________; 


4.  The mark is still in use in ____________________________ (Interstate) commerce   on or in connection with the goods specified in the registration; 


5.  The mark is used by _________________________________ (Printing the Mark on   the Goods), and the attached specimen shows the mark as currently used on or in connection with the goods; 


6.  There has been no final decision adverse to the registrant’s claim of ownership of       such mark for such goods or its right to register the same or keep the same on the           register, and there is no proceeding involving such right pending in the United States      Patent and Trademark Office or in a court and not finally disposed of.




Name of Corporation


By _________________________________________________________

     Signature and Title



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