Trademark Prosecution Strategy Consult Intake Form Are you making your filing as an individual or on behalf of a business?IndividualBusinessName First Last Contact Name First Last Email CompanyState of Formation (if known)Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country PhonePlease provide a short description of the types of goods and services to be identified by this trademark.Is this trademark currently in use? (Have you made a sale of goods using the mark or used it to sell or advertise services?)YesNoDoes your trademark consist of words, a logo, or a combination of words and a logo?WordsLogoCombinationType the wording you plan to use below. If you are considering more than one option for the Mark, enter all of them separated by commas.If the wording is stylized, colored, upload an image, if available.Upload an image of your logo, if available.What are your goals for obtaining Federal TM protection? (E.G., known competitors, national expansion, entrance into market/new market, name change in progress or under consideration, litigation)What type of business entity is the mark owner? (e.g. Partnership, LLC, PLLC, LLP, Corporation, etc...)Where was the business entity filing made? If formed in the US, list the State. If the business was formed internationally, list the Country. (List the location where the formation documents are filed, not the location the business was primarily operating)When did you first use the mark? (Enter the date you first used the mark in any form, even if there was no sale of goods or the business was not yet operating selling products.) Date Format: MM slash DD slash YYYY When did you first use the mark to identify goods or services that were sold? (includes giving out free samples) Date Format: MM slash DD slash YYYY When do you estimate the goods or services will be available? (with the mark affixed to the goods or services) Please explain.How do you plan to associate your mark with with the goods or services? (e.g., on labels, affixed directly on the goods, banners, packaging, advertisements, letterhead, domain name, etc.)Are samples available which show the mark used to identify your goods or services? If so, please upload an example.Are you aware of anyone using a mark the same as or similar to yours? Please explain any information that you have about their mark, goods, company, company location, sales market, who was first to use the mark, etc. Have you been in contact with the other company/individual? Please explainHave you applied for a trademark on this mark before in this or another country? Do you own any other trademark registrations or have any trademark applications pending that may be related to this mark? Please provide details.PhoneThis field is for validation purposes and should be left unchanged. This iframe contains the logic required to handle Ajax powered Gravity Forms.