Application for Registration of Trademark or Service Mark

Registering a trademark with the US patent office requires the use of the following application form.

Extracted Text for Proper Search

For Office Use Only  	
  Ed Murray 
 	Wyoming Secretary of State 	
   2020 Carey Avenue, Suite 700  
  Cheyenne, W Y 82002-0020 
  Ph. 307.777.7311  
  Fax 307.777.5339  
  Email: [email protected]	
  	
 	
TM -RegistrationApplication  – Revised  October 2015       
 	
Application for Registration of  Trademark or Service Mark 	
 
1.  Provide a written description of the trademark or service mark. Your description must include  all words, names, 
symbols, devices and designs which the applicant wishes to be included within the  mark. You may attach a separate sheet 
if needed; however, you must describe the trademark completely : 
 
 
 
2. Name of applicant:  
 
 
3. Business address of applicant:  
 
 
 
4. M ailing address of applicant : 
 
 
 
5. Applicant is  	
(check only one)	:   	 
   individual;         corporation;        general partnership;    	
limited partnership;       limited liability company ;     statutory trust;   	 	
unincorporated association;      other: 	
 
6. a. If the applicant is a corporation, limited partnership, limited liability compa ny or statutory trust, list: 
 
      The state  of incorporation  or organization:  
 
  The date incorporated or organized:  	
(Date – mm/dd/yyyy)  	 
 b. If a general partnership or limited partnership, list the names of the general partners or partners:  
 
 
 
  c. If a limited liabili ty company or statutory trust, list the names of the managers, members or trustees:  
 
 
 
  d. If other, explain:  
 
 
 
7. Provide the class number and	 title of the goods or services (see attachment) . Use only one class code per registration: 	
   
Class number:       Title:

TM-Regi strationApplication  – Revised  October  2015	 	
8. Provide a brief description of the goods or services within the class (i.e., what your product is, or what service you 
provide):  
 
 
9. List the mode or manner in which the mark is used to identify the goods or services (e.g.: goods -  labels on cans, bags, 
wrappers, etc.; tags, nameplates affixed directly to product; services -  labels on laundry bags, advertising, window signs, 
etc.):  
 
 
10. An application to register the mark or portions or a composite has been filed by the applicant or a predecess or in 
interest in the U.S. Patent and Trademark office:      Yes    No 
  If yes, provide filing date, serial number of each application, the status and, if any application was finally refused 
registration or has not otherwise resulted in registration, the rea sons therefore: 
 
 
11. Date of first use by applicant or predecessor (the mark must be in use	 before it can be registered) : 	 	
a. Anywh ere: 	
      (Date  – mm/dd/yyyy)  	 	
b. In this state : 	
      (Date  – mm/dd/yyyy)  	
 
12. One	 photocopy or facsimile of the mark as it  is actually used	 must accompany this application.  	
 
13. The applicant is the owner of the mark. The mark is in use and to the knowledge of the person verifying this 
application, no other person has registered, either federally or in this state, or has the right to use such mark either in the 
identical form thereof or in such near resemblance as to be likely, when applied to the goods or services of such other 
person, to cause confusion or to cause mistake or to deceive. 
 
Signature: ___________________________________________   Date: 
            (mm/dd/yyyy)  
 
Print Name:       Contact Person:  
 
Title:        Daytime Phone Number:  
 
Email:	
          (Email provided will receive filing evidence)  
         *May list multiple email addresses

TM-Regi strationApplication  – Revised  October  2015	 	
 
 
 
 
 
 
 
 
 
 
 
Important  Information : 
• Registration is effective for a term of five years and is renewable for like term upon application filed within six months pr ior to expiration of 
such term.  
• Renewal forms are mailed by the office of the Secretary of State to registrants whose  trademark or service mark is up for renewal. 
• A trademark or service mark may be canceled at any time upon written request to the Secretary of State and payment of a $10.0 0 filing fee. 
• Assignment forms are available on the internet or from the office of the Secretary of State upon request. The filing fee to assign a trademark 
or service mark is $25.00.  
• Copies of the Wyoming Trademark statutes are available via the internet at 
http://legisweb.state.wy.us/statutes/statutes.aspx?file=titles/Title40/T40CH1.htm	  	 
The following general classes of goods and services are established for convenience of administration of this Act,but not to limit or 
extend the applica nt’s or registrant’s rights. A single application for registration of a mark may include any and all goods upon 
which, or service with which, the mark is actually being used in a single class.  IF GOODS OR SERVICES FALL WITHIN TWO 
SEPARATE CLASS CODES, A S EPARATE REGISTRATION MUST BE SUBMITTED FOR EACH CLASS.  
 
Class Number and Title	 	 
Goods	 	
1. Raw or partly prepared materials  
2. Receptacles  
3. Baggage, animal equipment, portfolios, and pocketbooks  
4. Abrasives and polishing materials  
5. Adhesives  
6. Chemicals and chemical compositions   
7. Cordage  
8. Smokers’ articles, not including tobacco products  
9. Explosives, firearms, equipments, and projectiles   
10. Fertilizers  
11. Inks and inking materials   
12. Construction materials   
13. Hardware and plumbing and steam -fitting supplies  
14. Metals and metal castings and forgings   
15. Oils and greases   
16. Paints and painters’ materials  
17. Tobacco products   
18. Medicines and pharmaceutical preparations  
19. Vehicles  
20. Linoleum and oiled cloth  
21. Electrica l apparatus, machines, and supplies  
22. Games, toys, and sporting goods  
23. Cutlery, machinery, and tools, and parts thereof   
24. Laundry appliances and machines  
25. Locks and safes   
26. Measuring and scientific appliances   
27. Horological instruments   
28.  Jewelry and precious -metal ware  
29. Brooms, brushes and dusters  
30. Crockery, earthenware, and porcelain   
31. Filters and refrigerators   
 
  TM
-RegistrationApplication  - Revised  January 2015 
32. Furniture and upholstery   
33. Glassware  
34. Heating, lightin g and ventilating apparatus  
35. Belting, hose, machinery packing, non -metallic tires   
36. Musical instruments and supplies  
37. Paper and stationery  
38. Prints and publications  
39. Clothing 
40. Fancy goods, furnishings and notions  
41. Canes, parasols, and u mbrellas 
42. Knitted, netted and textile fabrics and substitutes therefor  
43. Thread and yarn  
44. Dental, medical, and surgical appliances  
45. Soft drinks and carbonated waters   
46. Foods and ingredients of foods  
47. Wines  
48. Malt beverages and liquors  
49. Distilled alcoholic liquors  
50. Merchandise not otherwise classified  
51. Cosmetics and toilet preparations  
52. Detergents and soaps  
 	
Services	 	
100. Miscellaneous  
101. Advertising and business  
102. Insurance and financial  
103. Construction and repair  
104.  Communications  
105. Transportation and storage  
106. Material treatment  
107. Education and entertainment  
 	
Checklist	 	
          Filing Fee: $100.00     Make check or money order payable to  Wyoming Secretary of State. 
           The Application must be accompanied by one photocopy or a facsimile of the trademark or service mark as it is actually  used.  
           The sworn application must be executed by the individual applicant or a member, man ager, trustee, partner, officer or director of the  
          applicant.  
          Please submit one originally signed  document .  
          Please review form prior to submitting to the Secretary of State to ensure all areas have been completed to avoid a d elay in  
          the processing of your documents.