Checklist For U.S. Trademark Applications Based On Actual Usage

1. The name of the applicant:
_________________________________________________

2. Is applicant the original owner of the mark or was there a prior owner?
_________________________________________________

3. Applicant is a:
corporation/incorporated
in ___________________________________________
person/citizen of partnership/formed
in ___________________________________________

3A. Partners:
name/citizen of ________________________________
name/citizen of ________________________________
name/citizen of ________________________________
limited _________ general _________
other _______________________________________

4. If the applicant is a corporation or association, the name and corporate title of the person who will be signing the application:
_________________________________________________

5. The business address and post office address of the applicant:
_________________________________________________
_________________________________________________

6. The mark sought to be registered:
_________________________________________________

7. If the mark is a word or phrase, is it used with a design?
Yes ________ No ________

7A. If yes, how often?
Sometimes ________ Always ________

8. The particular goods on which the mark is used:
_________________________________________________
_________________________________________________

9. How is the mark used (e.g., on labels or packaging)?
_________________________________________________

10. The date of applicant's first sale anywhere of the specified goods bearing the mark:
_________________________________________________

10A. Evidence of this use (e.g., an invoice copy):
is attached ________;
is unavailable because ___________________________
____________________________________________

11. The date of applicant's first sale across state lines of the specified goods bearing the mark:
_________________________________________________

11A. Evidence of this use:
is attached ________;
is unavailable because ___________________________
____________________________________________

12. Four (4) duplicate specimens of the mark as actually used (e.g., labels) that bear the trademark and which are normally affixed to the goods themselves or to packages containing the goods:
are enclosed ________;
are not enclosed because _________________________
_____________________________________________

13. Does applicant own any other registrations for the same mark or for a similar mark not obtained by this firm?
Yes ________ No ________

13A. If yes, what registrations were not obtained by this firm?
__________________________________________________

14. Is applicant using or considering use of the mark in a foreign country?
Yes ________ No ________

14A. If yes, list foreign countries.
_________________________________________________
_________________________________________________