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Kentucky Trademark Servicemark Application Form

In the case of wanting to apply for registering a trademark/servicemark in the State of Kentucky, the following form has to be completed and submitted along with a $40 filing fee.

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COMMONWEALTH OF KENTUCKY	 	
ALISON LUNDERGAN GRIMES	 	
SECRETARY OF STATE	 	
 
 	
Page 	1 of 	4 	
 	
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:	 	 
1. 	 The undersigned appli	cant is 	 	 an individual	  	    a corporation	 	 	 other organization	 	
        	(Must check one)	 	 	 a limited liabil	ity company	          	 a partnership	 	 	 ______________	____	 	 
2.  The applicant is applying for 	(Must check one)	    a trademark registration  	 a s	ervice mar	k registration	   	
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 appli	cant is a partnership, 	indicate the state of organization:	  __________	__________________________	_____	 	
    	 List the names of the general partners: 	 __	____________________________	___________________________	_____	 	 	 	 	 	 	 	 	 	 	(Attach a continuation sheet, if nec	essary)	 	 
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 Kentu	cky:	 ____	_________________	 	 
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 exclusiv	e right to use the te	rm____________________________	 	
      	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 fol	lowing	: I am the owner of the mark and it is in use in 	the Commonwealth	 of Kentucky. 	
To my knowledge no o	ther person has registered, either federally or in this state, or has the right to us	e 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 corr	ect	. 	  	___________________	_____________________________	 	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: _____________________________

Trademark/Service Mark Drawing Page	 	
 	
Page 	2 of 	4 	
 
 
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 
trad	e.  This drawing is intended to show only th	at 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 cl	aimed 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 	3 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	 	
 	
1. 	Indicate entity of Applicant, if “other organization” clarify on line below.	 	
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 Kent	uck	y.  	NOTE	: The mark must 	
be in use i	n 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 an	d 	
the applicant wishes to claim these features as part of the mark, then br	iefly describe in words th	e 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 wh	en 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 attor	ney for more information on dis	claimers 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 administ	ered	 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 mu	st show usage in the normal course of 	trade	 in the Commonwealth of Kentucky.	 	
 A trademar	k 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 ar	e not acceptable as specimens 	of use 	of the mark. 	
Photo	-ready or computer generated print	-outs are not acc	eptable	 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 	origina	l signed application, no additional copies are necessary. Photocop	ied 	
signature	s 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 	4 of 	4 	
 	
International Classification of Goods and Services
  	Classification of Goods:	 	 	1. Chemicals  used  in  industry, science  and  photography,  as  well  as i	n 	agriculture,  horticulture  and  forestry;  unprocessed  artificial  resins, unprocessed  plastics;  manures;  fire  extinguishing  compositions; tempering  and  soldering  preparation;  chemical  substances  for preserving foodstuffs; tanning substances; adhesives used 	in industry.	 	2. Paints,  varnishes,  lacquer;  preservatives  against  rust  and  against deterioration  of  wood;  colorants,  mordants;  raw  natural  resins;  metals in foil and powder form for painters, decorators, printers and artists.	 	3. Bleaching  preparations  and  other 	substances  for  laundry  use; 	cleaning  polishing,  scouring  and  abrasive  preparations;  soaps; perfumery, essential oils, cosmetics hair lotions; denitrifies.	 	4. Industrial  oils  and  greases;  lubricants;  dust  absorbing,  wetting  and binding  compositions;  fuels  (inc	luding  motor  spirit)  and  illuminates; 	candles, wicks.	 	5. Pharmaceutical,  veterinary  and  sanitary  preparations;  dietetic substances  adapted  for  medical  use,  food  for  babies;  plasters, materials  for  dressings;  material  for  stopping  teeth,  dental  wax; disinfecta	nts;  preparations  for  destroying  vermin,  fungicides, 	herbicides.	 	6. Common  metals  and  their  alloys;  metal  building  materials; transportable  buildings  of  metal;  materials  of  metal  for  railway  tracks; non	-electric  cables  and  wires  of  common  metal;  ironmongery, 	small 	items  of  metal  hardware;  pipes  and  tubes  of  metal;  safes;  goods  of common metal not included in other classes, ores.	 	7. Machines  and  machine  tools;  motors  and  engines  (except  for  land vehicles);  machine  coupling  and  transmission  components  (except  for land vehicles); agriculture implements; incubators for eggs.	 	8. Hand  tools  and  implements  (hand  operated);  cutlery;  side  arms; razors.	 	9. Scientific,  nautical,  surveying,  electric  photographic, cinematographic;  optical,  weighing,  measuring,  signaling,  checking (supervision),  life	-saving  and  teaching  apparatus  and  instruments; 	apparatus  for  recording,  transmission  or  reproduction  of  sound  or images;  magnetic  data  carriers,  recording  discs,  automatic  vending machines  and  mechanisms  for  coin	-operated  apparatus;  cash 	registers,  calculating  machines,  data  processing  equipment  and computers;  computer  software  and  games;  fire	-extinguishing 	apparatus.	 	10.	 Surgical,  medical,  dental  and  veterinary  apparatus  and 	instruments,  artificial  limbs,  eyes  and  teeth;  orthopedic  articles; 	suture 	materials.	 	11.	 Apparatus  for  lighting,  heating,  steam  generating,  cooking, 	refrigerating, drying, ventilating, water supply and sanitary purposes.	 	12.	 Vehicles; apparatus for locomotion by land, air or water.	 	13.	 Firearms; ammunition and projectiles; explosives	, fireworks.	 	14.	 Precious metals  and  their  alloys  and  goods  in  precious metals  or 	coated  therewith,  not  included  in  other  classes;  jewelry,  precious stones; horological and chronometric instruments.	 	15.	 Musical instruments.	 	16.	 Paper,  cardboard  and  goods  made  from  the	se  materials,  not 	included  in  other  classes;  printed  matter,  bookbinding  material; photographs;  stationery,  adhesives  for  stationery  or  household purposes;  artists'  materials;  paint  brushes;  typewriters  and  office requisites (except furniture); instruction	al and teaching material (except 	apparatus); playing cards; printers' type; printing blocks.	 	17.	 Rubber, gutta	-percha, gum asbestos, mica and goods made from 	these  materials  and  not  included  in  other  classes;  plastics  in  extruded form  for  use  in  manufacture;  p	acking,  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  includ	ed  in  other 	classes)  of  wood,  cork,  reed,  cane,  wicker,  horn,  bone  ivory, 	
whalebone,  shell,  amber,  mother	-of-pearl,  meerschaum  and 	substitutes for all these materials, or of plastics.	 	21.	 Household  or  kitchen  utensils  and  containers  (not  of  precious 	metal or c	oated therewith); combs and sponges; brushes (except paint 	brushes);  brush	-making materials;  articles  for cleaning  purposes;  steel 	wool; un	-worked or semi	-worked  glass (except glass used in building); 	glassware, porcelain and earthenware not included in ot	her classes.	 	22.	 Ropes,  string,  nets,  tents,  awnings,  tarpaulins,  sails,  sacks  and 	bags  (not  included  in  other  classes);  padding  and  stuffing  materials (except of rubber or plastics); raw fibrous textile materials.	 	23.	 Yarns and threads, for textile use.	 	24.	 Textiles 	and  textile  goods  not  included  in  other  classes;  bed  and 	table covers.	 	25.	 Clothing, footwear, headgear.	 	26.	 Lace  and  embroidery,  ribbons  and  braid,  buttons,  hooks  and 	eyes, pins and needles; artificial flowers.	 	27.	 Carpets rugs, mates and matting, linoleum and other 	materials for 	covering existing floors; wall hangings (non	-textile).	 	28.	 Games  and  playthings;  gymnastics  and  sporting  articles  not 	included in other classes; decorations for Christmas trees.	 	29.	 Meat, fish, poultry and game; meat extracts; preserved, dried and 	cooked  fruit  and  vegetables;  jellies,  jams,  fruit  sauces;  eggs,  milk  and milk products; edible oats and fats.	 	30.	 Coffee, tea, coca, sugar, rice, tapioca, sago, artificial coffee; flour 	and  preparations made  from  cereals,  bread,  pastry  and  confectionery, honey  t	reacle;  yeast,  baking	-powder,  salt,  mustard,  vinegar,  sauces 	(condiments); spices; ice.	 	31.	 Agricultural,  horticultural  and  forestry  products  and  grains  not 	included  in  other  classes;  live  animals;  fresh  fruits  and  vegetables; seeds, natural plants and flowers	; foodstuffs for animals, malt.	 	32.	 Beers, mineral and aerated waters and other non	-alcoholic drinks; 	fruit  drinks  and  fruit  juices;  syrups  and  other  preparations  for  making beverages.	 	33.	 Alcoholic beverages (except beers).	 	34.	 Tobacco; smokers' articles; matches.	 	 	Classification of Services	 	 35.	 Advertising;  business  management;  business  administration; 	office functions; retail, wholesale, distributorship services.	 	36.	 Insurance; financial affairs; monetary affairs; real estate affairs.	 	37.	 Building construction; repair, install	ation services.	 	38.	 Telecommunications.	 	39.	 Transport; packaging and storage of goods; travel arrangement.	 	40.	 Treat of materials.	 	41.	 Education;  providing  of  training;  entertainment;  sporting  and 	cultural activities.	 	42.	 Scientific  and  technological  services  and  research  and	 design 	relating  thereto;  industrial  analysis  and  research  services;  design  and development for computer hardware and software; legal services.	 	43.	 Services  for  providing  food  and  drink;  temporary 	accommodations.	 	44.	 Medical  services;  veterinary  services;  hygienic	 and  beauty  care 	for  human  beings  or  animals;  agriculture,  horticulture  and  forestry services.	 	45.	 Personal  and  social  services  rendered  by  others  to  meet  the 	needs  of  individuals;  security  services  for  the  protection  of  property and individuals.
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