"Trademark/Service Mark Application Form" - Kentucky

Trademark/Service Mark Application Form is a legal document that was released by the Kentucky Secretary of State - a government authority operating within Kentucky.

Form Details:

  • Released on January 1, 2012;
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COMMONWEALTH OF KENTUCKY
ALISON LUNDERGAN GRIMES
SECRETARY OF STATE
Trademark/Service Mark Application
Pursuant to the provisions of KRS 365.567 to 365.581, the undersigned hereby makes application for the registration of a
mark in Kentucky and for that purpose submits the following statements:
 an individual
 a corporation
 other organization
1. The undersigned applicant is
 a limited liability company
 a partnership
(
__________________
Must check one)
 a trademark registration  a service mark registration
2. The applicant is applying for
(Must check one)
3. The name of the applicant: _______________________________________________________________________
4. The business address of the applicant is: street address ________________________________________________
city________________________________ state ____________________________ zip code __________________
5. If the applicant is a corporation or limited liability company, indicate the state of incorporation/organization: _________
6. If the applicant is a partnership, indicate the state of organization: _________________________________________
List the names of the general partners: ______________________________________________________________
(Attach a continuation sheet, if necessary)
7. If applying for a trademark, list the goods offered or sold under the mark. If applying for a service mark, list the services
provided under the mark: _________________________________________________________________________
_____________________________________________________________________________________________
8. The manner in which the mark is used in association with the above goods or services: ________________________
_____________________________________________________________________________________________
_
9. The class comprising the goods or services: (refer to class listing on page 4) ________________________________
10. List the dates the mark was first used: (a) anywhere: ________________ (b) in Kentucky: _____________________
11. Describe the mark (words and/or design) as shown on the attached drawing page (do not draw design on application)
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
12. Disclaimer (if applicable*): No claim is made to the exclusive right to use the term____________________________
apart from the mark as shown. *see instructions
13. A drawing of all features of the mark for which ownership is claimed accompanies this application.
14. Three specimens showing actual use of the mark accompany this application.
The applicant declares the following: I am the owner of the mark and it is in use in the Commonwealth of Kentucky.
To my knowledge no other person has registered, either federally or in this state, or has the right to use the mark in this state
in an identical form or in such near resemblance as to be likely, when used on or in connection with the goods or services of
the other person to cause confusion or mistake, or to deceive.
I am ___________________________________ of ___________________________________________, the applicant herein, being first duly sworn,
say that I have read the above application and know the contents thereof, and that the facts set out therein are true, complete and correct.
________________________________________________
Signature
________________________________________________
State of ___________________________
Type or Print Name and Title
County of __________________________
Subscribed and sworn to before me this __________ day of ______________________, 20 _______.
_________________________________________________
Notary Public
(01/12)
My Commission Expires: _____________________________
Page 1 of 4
COMMONWEALTH OF KENTUCKY
ALISON LUNDERGAN GRIMES
SECRETARY OF STATE
Trademark/Service Mark Application
Pursuant to the provisions of KRS 365.567 to 365.581, the undersigned hereby makes application for the registration of a
mark in Kentucky and for that purpose submits the following statements:
 an individual
 a corporation
 other organization
1. The undersigned applicant is
 a limited liability company
 a partnership
(
__________________
Must check one)
 a trademark registration  a service mark registration
2. The applicant is applying for
(Must check one)
3. The name of the applicant: _______________________________________________________________________
4. The business address of the applicant is: street address ________________________________________________
city________________________________ state ____________________________ zip code __________________
5. If the applicant is a corporation or limited liability company, indicate the state of incorporation/organization: _________
6. If the applicant is a partnership, indicate the state of organization: _________________________________________
List the names of the general partners: ______________________________________________________________
(Attach a continuation sheet, if necessary)
7. If applying for a trademark, list the goods offered or sold under the mark. If applying for a service mark, list the services
provided under the mark: _________________________________________________________________________
_____________________________________________________________________________________________
8. The manner in which the mark is used in association with the above goods or services: ________________________
_____________________________________________________________________________________________
_
9. The class comprising the goods or services: (refer to class listing on page 4) ________________________________
10. List the dates the mark was first used: (a) anywhere: ________________ (b) in Kentucky: _____________________
11. Describe the mark (words and/or design) as shown on the attached drawing page (do not draw design on application)
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
12. Disclaimer (if applicable*): No claim is made to the exclusive right to use the term____________________________
apart from the mark as shown. *see instructions
13. A drawing of all features of the mark for which ownership is claimed accompanies this application.
14. Three specimens showing actual use of the mark accompany this application.
The applicant declares the following: I am the owner of the mark and it is in use in the Commonwealth of Kentucky.
To my knowledge no other person has registered, either federally or in this state, or has the right to use the mark in this state
in an identical form or in such near resemblance as to be likely, when used on or in connection with the goods or services of
the other person to cause confusion or mistake, or to deceive.
I am ___________________________________ of ___________________________________________, the applicant herein, being first duly sworn,
say that I have read the above application and know the contents thereof, and that the facts set out therein are true, complete and correct.
________________________________________________
Signature
________________________________________________
State of ___________________________
Type or Print Name and Title
County of __________________________
Subscribed and sworn to before me this __________ day of ______________________, 20 _______.
_________________________________________________
Notary Public
(01/12)
My Commission Expires: _____________________________
Page 1 of 4
Trademark/Service Mark Drawing Page
Drawing instructions:
The applicant must provide a drawing of the mark in addition to the three specimens showing the actual use of the mark in
trade. This drawing is intended to show only that which is claimed in the description of the mark under item 11 on the
application. If the mark consists of words, letters or numerals, or any combination thereof, and if the mark is not depicted
in a special form, or if this special form is not being claimed as a feature of the mark, the mark may be typed in capital
letters on the drawing page. If the mark includes a design, a drawing of the entire proposed mark (in clean, uniform black
lines) must be attached to the application. If color is claimed as a feature of the mark, it should be indicated where
appropriate on the drawing.
Application Check List:
___ The original signed and notarized application
___ Three specimens showing actual use of the mark
___ Drawing page
___ Application processing fee of $10 per class
Page 2 of 4
Instructions for completing the KY Trademark Service Mark Application
NOTE:
Application must be completed, including the notary section at the bottom.
Application must be verified and signed by the Applicant or an authorized agent of the Applicant, whose title must be
declared under oath.
LINE-BY-LINE INSTRUCTIONS
Indicate entity of Applicant, if “other organization” clarify on line below.
1.
2.
Must mark only one box. If applying for both trademark and service mark, must use separate applications.
3.
Print name of Applicant, must include any formal corporate ending.
4.
Print complete business address.
5.
This applies only to corporations and limited liability companies, print state of organization.
6.
This applies only to organized partnerships, print state of organization.
7.
State the products or services associated with the mark.
8.
State the way the mark is used to distinguish and identify the products or services listed in item 7.
9.
State the classification, by number, that best represents the products or services listed in item 7. Class listing is on page 4 of
this application packet.
10. State the earliest date that the mark was used in trade anywhere and the date first used in Kentucky. NOTE: The mark must
be in use in KY prior to registration.
11. State the mark in words exactly as it is to be registered. If the mark involves a symbol, design, or nonstandard typeface and
the applicant wishes to claim these features as part of the mark, then briefly describe in words the features of design. This is
the way the mark will be registered, and this is the way it should appear on the drawing page.
NOTE: A single application may not be used to seek registration of variations of a term or design.
12. A disclaimer is used when there are unregistrable components of an otherwise registrable mark. Generally, elements that are
descriptive or generic of the goods /services are unregistrable and should be disclaimed. You may call the office, visit our
website, or consult an attorney for more information on disclaimers and disclaimed elements.
13. The applicant must include a drawing page which depicts the mark exactly as described in item 11 of the application.
Signing the application: The applicant must swear under an oath administered by a notary public that the information is true and
correct and must sign the application in the presence of a notary public.
SPECIMENS OF USE: The application must be accompanied by three (3) specimens showing the mark as actually used.
A specimen must show usage in the normal course of trade in the Commonwealth of Kentucky.
A trademark specimen may include the following: label, tag, a picture or impression of the mark stamped on, printed on
or otherwise applied to goods.
A service mark specimen may include the following: advertisement, brochure, flier. Note: business cards and stationery
may be acceptable provided that they show a connection between the mark and the services offered.
NOTE: Names or marks typed, printed or written on plain paper are not acceptable as specimens of use of the mark.
Photo-ready or computer generated print-outs are not acceptable specimens of use.
FILING FEES: The filing fee for Trademark/Service Mark application is $10.00 per class.
When a single application includes goods or services falling in multiple classes, a fee of $10.00 is required for each class.
Your check should be made payable to the Secretary of State.
NUMBER OF COPIES: Submit the original signed application, no additional copies are necessary. Photocopied
signatures are not accepted.
MAILING ADDRESS: Secretary of State
Trademark Division
PO Box 718,
Frankfort, KY 40602-0718
Registration Period: Registration is effective for a term of five years from the date of registration. Registration can be
renewed by filing for renewal within six months prior to the expiration of the registration.
Contact Information:
For further information, call (502) 564-3490
Visit our website to review trademark/service mark FAQs and to perform online searches: www.sos.ky.gov
Page 3 of 4
International Classification of Goods and Services
Classification of Goods:
1. Chemicals used in industry, science and photography, as well as in
whalebone,
shell,
amber,
mother-of-pearl,
meerschaum
and
agriculture, horticulture and forestry; unprocessed artificial resins,
substitutes for all these materials, or of plastics.
unprocessed plastics; manures; fire extinguishing compositions;
21. Household or kitchen utensils and containers (not of precious
tempering and soldering preparation; chemical substances for
metal or coated therewith); combs and sponges; brushes (except paint
preserving foodstuffs; tanning substances; adhesives used in industry.
brushes); brush-making materials; articles for cleaning purposes; steel
2. Paints, varnishes, lacquer; preservatives against rust and against
wool; un-worked or semi-worked glass (except glass used in building);
deterioration of wood; colorants, mordants; raw natural resins; metals
glassware, porcelain and earthenware not included in other classes.
in foil and powder form for painters, decorators, printers and artists.
22. Ropes, string, nets, tents, awnings, tarpaulins, sails, sacks and
3. Bleaching preparations and other substances for laundry use;
bags (not included in other classes); padding and stuffing materials
cleaning polishing, scouring and abrasive preparations; soaps;
(except of rubber or plastics); raw fibrous textile materials.
perfumery, essential oils, cosmetics hair lotions; denitrifies.
23. Yarns and threads, for textile use.
4. Industrial oils and greases; lubricants; dust absorbing, wetting and
24. Textiles and textile goods not included in other classes; bed and
binding compositions; fuels (including motor spirit) and illuminates;
table covers.
candles, wicks.
25. Clothing, footwear, headgear.
5. Pharmaceutical, veterinary and sanitary preparations; dietetic
26. Lace and embroidery, ribbons and braid, buttons, hooks and
substances adapted for medical use, food for babies; plasters,
eyes, pins and needles; artificial flowers.
materials for dressings; material for stopping teeth, dental wax;
27. Carpets rugs, mates and matting, linoleum and other materials for
disinfectants;
preparations
for
destroying
vermin,
fungicides,
covering existing floors; wall hangings (non-textile).
herbicides.
28. Games and playthings; gymnastics and sporting articles not
6. Common metals and their alloys; metal building materials;
included in other classes; decorations for Christmas trees.
transportable buildings of metal; materials of metal for railway tracks;
29. Meat, fish, poultry and game; meat extracts; preserved, dried and
non-electric cables and wires of common metal; ironmongery, small
cooked fruit and vegetables; jellies, jams, fruit sauces; eggs, milk and
items of metal hardware; pipes and tubes of metal; safes; goods of
milk products; edible oats and fats.
common metal not included in other classes, ores.
30. Coffee, tea, coca, sugar, rice, tapioca, sago, artificial coffee; flour
7. Machines and machine tools; motors and engines (except for land
and preparations made from cereals, bread, pastry and confectionery,
vehicles); machine coupling and transmission components (except for
honey treacle; yeast, baking-powder, salt, mustard, vinegar, sauces
land vehicles); agriculture implements; incubators for eggs.
(condiments); spices; ice.
8. Hand tools and implements (hand operated); cutlery; side arms;
31. Agricultural, horticultural and forestry products and grains not
razors.
included in other classes; live animals; fresh fruits and vegetables;
9. Scientific,
nautical,
surveying,
electric
photographic,
seeds, natural plants and flowers; foodstuffs for animals, malt.
cinematographic; optical, weighing, measuring, signaling, checking
32. Beers, mineral and aerated waters and other non-alcoholic drinks;
(supervision), life-saving and teaching apparatus and instruments;
fruit drinks and fruit juices; syrups and other preparations for making
apparatus for recording, transmission or reproduction of sound or
beverages.
images; magnetic data carriers, recording discs, automatic vending
33. Alcoholic beverages (except beers).
machines and mechanisms for coin-operated apparatus; cash
34. Tobacco; smokers' articles; matches.
registers, calculating machines, data processing equipment and
Classification of Services
computers;
computer
software
and
games;
fire-extinguishing
apparatus.
35. Advertising; business management; business administration;
10. Surgical,
medical,
dental
and
veterinary
apparatus
and
office functions; retail, wholesale, distributorship services.
instruments, artificial limbs, eyes and teeth; orthopedic articles; suture
36. Insurance; financial affairs; monetary affairs; real estate affairs.
materials.
37. Building construction; repair, installation services.
11. Apparatus for lighting, heating, steam generating, cooking,
38. Telecommunications.
refrigerating, drying, ventilating, water supply and sanitary purposes.
39. Transport; packaging and storage of goods; travel arrangement.
12. Vehicles; apparatus for locomotion by land, air or water.
40. Treat of materials.
13. Firearms; ammunition and projectiles; explosives, fireworks.
41. Education; providing of training; entertainment; sporting and
14. Precious metals and their alloys and goods in precious metals or
cultural activities.
coated therewith, not included in other classes; jewelry, precious
42. Scientific and technological services and research and design
stones; horological and chronometric instruments.
relating thereto; industrial analysis and research services; design and
15. Musical instruments.
development for computer hardware and software; legal services.
16. Paper, cardboard and goods made from these materials, not
43. Services
for
providing
food
and
drink;
temporary
included in other classes; printed matter, bookbinding material;
accommodations.
photographs; stationery, adhesives for stationery or household
44. Medical services; veterinary services; hygienic and beauty care
purposes; artists' materials; paint brushes; typewriters and office
for human beings or animals; agriculture, horticulture and forestry
requisites (except furniture); instructional and teaching material (except
services.
apparatus); playing cards; printers' type; printing blocks.
45. Personal and social services rendered by others to meet the
17. Rubber, gutta-percha, gum asbestos, mica and goods made from
needs of individuals; security services for the protection of property
these materials and not included in other classes; plastics in extruded
and individuals.
form for use in manufacture; packing, stopping and insulating
materials; flexible pipes, not of metal.
18. Leather and imitations of leather, and goods made of these
materials and not included in other classes; animal skins, hides, trunks
and traveling bags; umbrellas, parasols and walking sticks; whips,
harness and saddlery.
19. Building materials (non-metallic); non-metallic rigid pipes for
building; asphalt, pitch and bitumen; non-metallic transportable
buildings; monuments, not of metal.
20. Furniture, mirrors, picture frames; goods (not included in other
classes) of wood, cork, reed, cane, wicker, horn, bone ivory,
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