Trademark Intake Form

Step 1 of 5

Who will be the owner of the trademark?*
- a business
- an individual

Company Information
Name of company*
Name of contact person*
Type of entity*
- Corporation
- LLC
- Partnership
State of formation*

Individual Information
Name*
Citizenship*

Email*
Phone*
Website*
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Trademark Information
Trademark to be protected*
If trademark is a logo, please describe the logo, and we will contact you regarding submission of the actual design.
Trademark First Used in Commerce*
Date Format: MM slash DD slash YYYY
Trademark First Conceived*
Date Format: MM slash DD slash YYYY
Goods or Services the Trademark is Used to Promote/Sell*

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