Law Office of Michael G. Burnett

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TRADEMARK APPLICATION DATA FORM

Select one of the following and fill out that section:

TM is owned by a BUSINESS

Name of Company

Corporate Form (Partnership, LLC, Corp, etc.)

State of Incorporation/Organization

TM is owned by an INDIVIDUAL

Full Name

Citizenship

Contact Information

Address
(Required)

City
(Required)

State
(Required)

ZIP
(Required)

Telephone
(Required)

Fax

Website

Email
(Required)

Trademark Information

Trademark(s) to be protected:
(If trademark is a logo, please describe here.)
(Required)

Date of First Use:	or Intent to use
Date of First use in Interstate Commerce	or Intent to use

(Required)

(Nearest month is acceptable if exact date is unknown.)
(Use in Commerce for goods = goods are sold or transported in commerce;
Use in Commerce for services = when trademark is used or displayed in the sale or advertising of services)

Goods or Services the Trademark is Used to Promote/Sell:
(Required)

Additional Comments/Questions

The use of the Internet for communications with the firm will not establish an attorney-client relationship and messages containing confidential or time-sensitive information should not be sent.

Law Office of Michael G. Burnett

P.O. Box 540310
Omaha, NE 68154

Phone: 402-333-0505
Fax: 402-333-6678

mgb@mgburnett.com
www.mgburnett.com

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Value

· Flat fees for many attorney services

· No hidden costs

· Free initial consultations available