Trade and Service Marks--Registration (Oregon)
This is a registration for trademark and service mark in Oregon. The form provided here is simply a sample of what the actual Form CR171 looks like.
CR171 (Rev. 12/99)
Phone: (503) 986-2200
Fax: (503) 378-4381
Secretary of State
Corporation Division
255 Capitol St. NE, Suite 151
Salem, OR 97310-1327
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For office use only
Registry Number: ________________________________
Attach Additional Sheet if Necessary
Please Type or Print Legibly in Black Ink
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Trade and Service Marks--Registration
1) CORRESPONDENT NAME AND MAILING ADDRESS
Address _______________________________
City _______________________________
State _______________________________
Zip _______________________________
2) APPLICANT'S NAME AND ADDRESS (Owner)
Address _______________________________
City _______________________________
State _______________________________
Zip _______________________________
3) IF THE APPLICANT IS A CORPORATION, ENTER THE STATE OF INCORPORATION.
_______________________________
_______________________________
4) DESCRIPTION OF TRADE OR SERVICE MARK
_______________________________
_______________________________
5) SPECIMEN OR FACSIMILE OF MARK IS REQUIRED.
A specimen or facsimile of the mark is attached to this application.
6) GOODS OR SERVICES WITH WHICH THE MARK IS USED (Examples of goods are pizzas, shirts; examples of services are serving food and selling clothing.)
_______________________________
_______________________________
7) EXPLAIN MODE OR MANNER IN WHICH THE MARK IS USED (Example: on goods, tags, labels, containers, etc.)
_______________________________
_______________________________
8) CLASS NUMBER(S) OF GOODS OR SERVICES (See list on reverse side.)
_______________________________
_______________________________
9) DATE MARK WAS FIRST USED ANYWHERE BY APPLICANT OR APPLICANT'S PREDECESSOR
_______________________________
10) DATE MARK WAS FIRST USED IN OREGON BY APPLICANT OR APPLICANT'S PREDECESSOR
_______________________________
11) EXECUTION
Applicant believes that applicant is the owner of the mark and no other person has the right to use such mark in Oregon, either in the identical form thereof, or in such near resemblance thereto, as might be calculated to deceive, or to be mistaken therefor, and applicant declares under penalties of perjury that this application is true, correct and complete.
Signature: _______________________________
Date: _______________________________
12) CONTACT NAME _______________________________
DAYTIME PHONE NUMBER - INCLUDING AREA CODE __________________
FEES
Make check for $20 payable to "Corporation Division." Registration is good for five years from the date of registration.