Application for Certificate of Renewal of a Registered Mark (Connecticut)
This is an application to renew a registered mark in Connecticut. The form provided here is simply a sample of what the actual Form TM 501 looks like.
OFFICE OF THE SECRETARY OF THE STATE
30 TRINITY STREET
P.O. BOX 150470
HARTFORD, CT 06 1150470
APPLICATION FOR CERTIFICATE OF RENEWAL OF A REGISTERED MARK, Rev. 12/1999
(Can be filed only within 6 months prior to the expiration of a registration)
1. Name of Record Owner: __________________________
2. State of Formation of the Owner if other than a natural person.
3. New Address of Owner (if applicable):
Zip Code __________________________
4. Connecticut Registration Number: __________________________
The owner of the mark, which is the subject of this application, asserts that the mark has been and is still in use in Connecticut. The owner hereby applies for renewal of the registration bearing the number stated in Number 4 above.
I hereby declare under the penalties of false statement that the statements made in the foregoing application is true.
5. Date __________________________
6. Name of Signatory __________________________
7. Title of Signatory if applicable __________________________
8. Signature __________________________
9. The applicant must submit three specimens or photographs of the mark as actually used in this state.