TRADEMARK INFORMATION SHEET

Date:

Name:

City:

Street:

State and Zip Code:

Telephone Number:

Address:

E-mail Address:

1. Provide the name, symbol or design of the proposed mark:

If mark includes a design include a sketch of the design and fax to our office with a completed copy of this form: Our fax number is 760-747-3951.

2. If mark is not in use, provide date that you intend to use mark in either intrastate or interstate commerce:

3. If mark is in use, provide:

The date and name of state the mark was first used in intrastate commerce:

The date the mark was first used in Internet commerce (leave blank if mark has only been used in a single state):

4. Provide a brief description of the goods or services to which the mark will be applied:

Cut and paste a completed copy of this form in an e-mail message and we will promptly reply by providing you with a free fixed price quote for conducting a trademark search and for preparing and filing a trademark application on your behalf. All communications with our office are held in the strictest confidence. No work will be undertaken until you have authorized such work by signing and returning a copy of our fee policy agreement. For other trademark services, see our schedule of fees.