| PTO Form 1963 (Rev 5/2006) |
| OMB No. 0651-0055 (Exp 07/31/2018) |
Combined Declaration of Use and/or Excusable Nonuse/Application for Renewal of Registration of a Mark under Sections 8 & 9
The table below presents the data as entered.
Input Field
|
Entered
|
| REGISTRATION NUMBER |
0930839 |
| REGISTRATION DATE |
03/14/1972 |
| SERIAL NUMBER |
72381004 |
| MARK SECTION |
| MARK |
ZILCH (stylized and/or with design) |
| CORRESPONDENCE SECTION (current) |
| NAME |
CONSTANCE LEBARON |
| FIRM NAME |
1289 REAMWOOD AVE STE E |
| CITY |
SUNNYVALE |
| STATE |
California |
| POSTAL CODE |
94089-2261 |
| COUNTRY |
United States |
| CORRESPONDENCE SECTION (proposed) |
| NAME |
LEBARON, CONSTANCE |
| STREET |
1289 Reamwood Ave., Ste E |
| CITY |
SUNNYVALE |
| STATE |
California |
| POSTAL CODE |
94089 |
| COUNTRY |
United States |
| PHONE |
408-734-9558 |
| FAX |
408-734-9432 |
| EMAIL |
twinsoncl@aol.com |
| AUTHORIZED TO COMMUNICATE VIA E-MAIL |
Yes |
| GOODS AND/OR SERVICES SECTION |
| U.S. CLASS |
022 |
| GOODS OR SERVICES |
GAME USING DICE |
| SPECIMEN FILE NAME(S) |
\\TICRS\EXPORT11\IMAGEOUT 11\723\810\72381004\xml2\ S890002.JPG |
| SPECIMEN DESCRIPTION |
Zilch mark and design |
| OWNER SECTION (current) |
| NAME |
LEBARON, CONSTANCE |
| CITY |
SUNNYVALE |
| STATE |
California |
| ZIP/POSTAL CODE |
94089 |
| COUNTRY |
United States |
| OWNER SECTION (proposed) |
| NAME |
LEBARON, CONSTANCE |
| DBA/AKA/TA/Formerly |
DBA TWINSON COMPANY |
| STREET |
1289 Reamwood Ave., Ste E |
| CITY |
SUNNYVALE |
| STATE |
California |
| ZIP/POSTAL CODE |
94089 |
| COUNTRY |
United States |
| PHONE |
408-734-9558 |
| FAX |
408-734-9432 |
| EMAIL |
XXXX |
| AUTHORIZED TO COMMUNICATE VIA E-MAIL |
Yes |
| LEGAL ENTITY SECTION (current) |
| TYPE |
individual |
| COUNTRY OF CITIZENSHIP |
United States |
| PAYMENT SECTION |
| NUMBER OF CLASSES |
1 |
| NUMBER OF CLASSES PAID |
1 |
| SUBTOTAL AMOUNT |
500 |
| TOTAL FEE PAID |
500 |
| SIGNATURE SECTION |
| SIGNATURE |
/Constance LeBaron/ |
| SIGNATORY'S NAME |
Constance LeBaron |
| SIGNATORY'S POSITION |
owner |
| DATE SIGNED |
03/14/2012 |
| SIGNATORY'S PHONE NUMBER |
408-734-9558 |
| PAYMENT METHOD |
CC |
| FILING INFORMATION |
| SUBMIT DATE |
Wed Mar 14 19:13:23 EDT 2012 |
| TEAS STAMP |
USPTO/S08N09-XX.XX.XXX.XX
-20120314191323267288-093
0839-4909cc88c526a52ec069
5e1a958761289e-CC-7959-20
120314183543473632 |
| PTO Form 1963 (Rev 5/2006) |
| OMB No. 0651-0055 (Exp 07/31/2018) |
Combined Declaration of Use and/or Excusable Nonuse/Application for Renewal of Registration of a Mark under Sections 8 & 9
To the Commissioner for Trademarks:
REGISTRATION NUMBER: 0930839
REGISTRATION DATE: 03/14/1972
MARK: (Stylized and/or with Design, ZILCH)
The owner, CONSTANCE LEBARON, DBA TWINSON COMPANY, a citizen of United States, having an address of
1289 Reamwood Ave., Ste E
SUNNYVALE, California 94089
United States
is filing a Combined Declaration of Use and/or Excusable Nonuse/Application for Renewal of Registration of a Mark under Sections 8 & 9.
For U.S. Class 022, the mark is in use in commerce on or in connection with
all goods/services, or to indicate membership in the collective membership organization, listed in the existing
registration for this specific class: GAME USING DICE ; or, the owner is making the listed excusable nonuse claim.
The owner is submitting one(or more) specimen(s) showing the mark as used in commerce on or in connection with any item in this class, consisting of a(n) Zilch mark and design.
Specimen File1
The registrant's current Correspondence Information: CONSTANCE LEBARON of 1289 REAMWOOD AVE STE E
SUNNYVALE, California (CA) 94089-2261
United States
The registrant's proposed Correspondence Information: LEBARON, CONSTANCE
1289 Reamwood Ave., Ste E
SUNNYVALE, California (CA) 94089
United States
The phone number is 408-734-9558.
The fax number is 408-734-9432.
The email address is twinsoncl@aol.com.
A fee payment in the amount of $500 will be submitted with the form, representing payment for 1 class(es), plus any additional grace period fee, if necessary.
Declaration
Section 8: Declaration of Use and/or Excusable Nonuse in Commerce
Unless the owner has specifically claimed excusable nonuse, the mark is in use in commerce on or in connection with the goods and/or services identified above, as evidenced by the attached
specimen(s) showing the mark as used in commerce.
The undersigned being hereby warned that willful false statements and the like are punishable by fine or imprisonment, or both, under 18 U.S.C. Section 1001, and that such willful false statements
and the like may jeopardize the validity of this document, declares that he/she is properly authorized to execute this document on behalf of the Owner; and all statements made of his/her own
knowledge are true and that all statements made on information and belief are believed to be true.
Section 9: Application for Renewal
The registrant requests that the registration be renewed for the goods/services/collective organization identified above.
Signature: /Constance LeBaron/ Date: 03/14/2012
Signatory's Name: Constance LeBaron
Signatory's Position: owner
Signatory's Phone Number: 408-734-9558
Serial Number: 72381004
Internet Transmission Date: Wed Mar 14 19:13:23 EDT 2012
TEAS Stamp: USPTO/S08N09-XX.XX.XXX.XX-20120314191323
267288-0930839-4909cc88c526a52ec0695e1a9
58761289e-CC-7959-20120314183543473632
