`E] AMENDMENTSTAGE weCHANGE
` BLICATION/REGISTMTIONSTAGE
`. Name: ’Rm’Le[[§ray L.O.ll(_}__ Date ;
`SerialNo._;_ 3 i
`
`/02
`
`INSTRUCTIONS: Plce a checkmark in the appropriate column and/or box
`Leal Instrument Examiner
`IE
`— Amended
`
`indicat hich data elements have been amended/coded.
`
`Data Element Prime/Intemational Class
`
`A
`
`El Goods and Services
`
`First Use Date
`
`In Another Form"
`
`Cl First Use in Commerce Date
`
`El Certification
`
`I Mark Data
`
`Misc. Mark Data
`
`Foreign Reg. Data
`
`Cl Word Mark
`Cl Mark Drawing Code
`
`El Scan Sub Drawing
`
`El ark Description
`Cl Lining/Stippling
`El Translation
`
`E] Section 2(t) Entire Mark
`
`Cl Section 2(1) Limitation Statement
`
`El Amended Register
`
`EIEIEIDEIEJEll]
`
`Cl Foreign Country
`Foreign Application Number
`‘Tl
`oreign Registration Number
`Foreign Registration Expiration Date
`oreign Reg. Renewal Expiration Date
`
`0*“
`
`>
`
`wner Name
`
`.
`
`ddress 1
`Q42
`Zip Code
`Citizenship
`Entity Statement
`
`EIEIDEI
`
`AmdlCorr Restr.
`Prior .S. Reg.
`_
`Correspondence
`
`H
`
`Cl Assign1nent(s)/Name Change
`El Concurrent Use
`El rir Registration
`El Attorney
`El Attorney DocketNumber
`
`I certify tat all corretin ae been enters in accrance with text editing guidelines.
`
`Cl Correspondence Firm Name/Address
`
`______.$@_GM__
`LIE
`
`Cl Pseudo Mark
`El Design Search Code
`
`Cl Disclaimer
`Cl Name/Portrait/Consent
`
`Cl Section 2(f) in Part
`
`Cl Amended Register Date
`
`Cl 44d / 446
`Cl Foreign Application Filing Date
`El Foreign Registration Date
`I] Foreign Renewal Reg. Number
`[I Foreign Renewal Reg. Date
`
`U DBA/AKA/TA
`
`Cl Address 2
`El State
`
`El Owner’s E-mail / Phone
`[3 Entity
`El Composed of
`
`Cl Domestic Representative
`Cl Correspondence E-mail / Phone
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