Alabama Trademark Registration Application Form

To register a trademark with Alabama’s Secretary of State, applicant must follow the instructions reflected in this form. After perusal, the form must be completed and then submitted to the Office of the Secretary of State along with the $30.00 registration fee.Download

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STATE OF ALABAMA 
 
 
APPLICATION TO REGISTER TRADEMARK,   
SERVICE MARK OR TRADE NAME IN ALABAMA 
 	
  1. Applicant Name	 (Individual, Corporation, Partnership, LLC or LLP) 	
 	
 2. Applicant  is registered in the State of ___________as a(n)
(  )  unincorporated              (  )  non-profit        (  )  corporation     
(  )  limited liability company    (  ) partnership       (  )  individual  
( )   sole proprietor             ( )   limite	
 d liability partnership 
(  )  other _____________________________________________	
State 	 Street Address                        City                            County 	 Telep hone 
 (    ) 	  Zip 	
   4.   Description of Mark 
   3. List names and addresses of partners (if applicable) 
    5. Description of goods, services or business provided under the Mark
           6. Mode or manner 
of in which the Mark is used with the goods, services 
     or business provided 
 
 
 
7. Classification Number	:                   	Classification Type:	             	            
         ___________                       ____Good and Services
 ____Business  
                            	
  	
 8. Mark Type:   Trademark______  Trade Name ______ Service Mark  ______
  
  
    	
  9.   Disclaimer 	(if applicable)                            	                               10. Consent 	(if applicable) 
            
      
    
       
                                                               	
  11a.Date and state of Mark origination: 
 
      ______________________________in ___________        11b.    Date in which the Mark was first used in Alabama: 
 
           ________________________________ 
  12. Attach three (3) specimens  which exhibit the Mark in use. 
  13. Attach the filing fee of thirty dollars ($30. 00) payable to the Alabama Secretary of State. 
  14. Sign the application for registration before a Notary Public. 
I, ___________ ____________________, b efore first duly   sworn,  at test that I  am the owner  of   the Mark,  a member of  the f irm, or  an officer   of th e 
corporation (or association) applying for the registration of the Mark above. I belie ve no other person has the right to use the Trademark, Service Mark 
or Trade Name in Alabama in identical form thereof or in s uch ne ar resemblance to deceive or cause to be m istaken pursuant to § 8-12-8(a) (4), C ode 
of Alabama 197 5. An y  exceptions are provided   for in  Item 10 .  I ha ve th e  authority  to m ake thi s affidav it and   verification. I h ave r ead th e ab ove 
foregoing application and know the contents and the facts set out  therein are true. I further attest that the three specimens filed are true and correct.	
 	
                                                                             
                                                                                                       Signature _______________________________________ 
 
Name __________________________________________________________  Title____________________________________________________ 
 
Section below to be completed by Notary Public	 	Subscribed and sworn to before me this the __________ day of ______________________________, 20__________. 
 
COUNTY OF _____________________________      STATE OF ____________________________________ 
 
_________________________________________               ______ __________________________________   ________ ________________________ ________ 
Notary Public Name                                                               Notary Public Signature                                              Commission Expiration Date 
 
Revision Date    7/2011