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                TRADEMARK QUESTIONNAIRE                                                                                           
                Purpose The
                purpose of this Trademark Questionnaire is to (1) clarify the
                process of choosing of a trademark; (2) create a legal document
                recording the dates of adoption and use; and (3) facilitate a
                higher quality and less expensive trademark application.                                                                                           
                Overview Generally,
                the following major pieces of information will expedite
                trademark prosecution.              
                (1)       
                Drawings, specimens or facsimiles of the trademark
                (preferably as actually affixed to the goods or services on
                which the mark has been or will be used).            
                (2)       
                A written description of all the goods or services on
                which the mark has been or will be used.            
                (3)       
                The dates of adoption, first use in commerce and first
                use in interstate commerce.                                                                                    
                Specific Information The
                following pieces of specific information are necessary for
                efficient trademark prosecution. 
                Attach additional pages as necessary. 1.        
                Name, address and citizenship of applicant (owner of
                mark).   2.        
                Entity type of applicant -- individual, partnership,
                corporation (including state of incorporation), other. 
                _______________________________________________________________________________ 3. Describe in detail all goods and/or services on which the mark has been or will be used. __________________________________________________________________________________            
                __________________________________________________________________________________ This
                is not a substitute for legal advice.  An
                attorney must be consulted.  | 
            
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                Prior to Adoption of Mark A
                trademark clearance search is highly recommended prior to
                adoption of the mark. 4.        
                First choice for preferred mark.  
                _______________            
                Second choice for preferred mark.  
                ____________            
                Third choice for preferred mark.  
                ______________ 5.        
                Is there a design, stylization, color or graphic aspect
                to mark?  If so, describe.  __________________________________________________________________________________                                                                                   
                After Adoption of Mark 6.        
                Date of first use in commerce. 
                ______________________ 7.        
                Date of first use in interstate commerce. 
                ______________________ 8.        
                Has mark been used continuously since the first use?  _____________________ 9.        
                Attach three (3) specimens or facsimiles (i.e., labels,
                tags, engravings, stampings, etc.) of the mark as it is actually
                applied to the goods or services. 10.      
                Describe any similar marks used by others and the goods
                or services on which they are used. 
                __________________________________________________________________________________            
                __________________________________________________________________________________ This
                is not a substitute for legal advice.  An
                attorney must be consulted.  | 
            
This is not a substitute for legal
advice.  An
attorney must be consulted.
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