| PTO Form 1963 (Rev 5/2006) |
| OMB No. 0651-0055 (Exp 10/31/2008) |
Combined Declaration of Use In Commerce & 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 |
1374539 |
| REGISTRATION DATE |
12/10/1985 |
| SERIAL NUMBER |
73520081 |
| MARK SECTION |
| MARK |
ETHAMOLIN |
| OWNER SECTION (current) |
| NAME |
BLOCK DRUG COMPANY, INC. |
| STREET |
257 CORNELISON AVENUE |
| CITY |
JERSEY CITY |
| STATE |
NJ |
| ZIP/POSTAL CODE |
073029988 |
| COUNTRY |
US |
| OWNER SECTION (proposed) |
| NAME |
QOL Medical LLC |
| STREET |
12419 198th Dr. NE |
| CITY |
Woodinville |
| STATE |
Washington |
| ZIP/POSTAL CODE |
98077 |
| COUNTRY |
United States |
| ATTORNEY SECTION |
| NAME |
Sarah A. Crain, Esq. |
| FIRM NAME |
Winthrop & Weinstine, P.A. |
| INTERNAL ADDRESS |
Suite 3500 |
| STREET |
225 South 6th Street |
| CITY |
Minneapolis |
| STATE |
Minnesota |
| ZIP/POSTAL CODE |
55402 |
| COUNTRY |
United States |
| PHONE |
612-604-6582 |
| FAX |
612-604-6982 |
| EMAIL |
scrain@winthrop.com |
| AUTHORIZED TO COMMUNICATE VIA E-MAIL |
Yes |
| DOCKET NUMBERS |
10718 |
| OTHER APPOINTED ATTORNEY(S) |
Stephen R. Baird, Troy E. Arnlund |
| GOODS AND/OR SERVICES SECTION |
| INTERNATIONAL CLASS |
005 |
| KEEP EXISTING GOODS AND/OR SERVICES |
YES |
| SPECIMEN FILE NAME(S) |
\\TICRS\EXPORT8\IMAGEOUT8 \735\200\73520081\xml2\S8 90002.JPG |
| SPECIMEN DESCRIPTION |
product packaging |
| PAYMENT SECTION |
| NUMBER OF CLASSES |
1 |
| NUMBER OF CLASSES PAID |
1 |
| SUBTOTAL AMOUNT |
500 |
| TOTAL AMOUNT |
500 |
| SIGNATURE SECTION |
| SIGNATURE |
/T G Blake/ |
| SIGNATORY NAME |
Trevor G Blake |
| SIGNATORY DATE |
12/05/2005 |
| SIGNATORY POSITION |
Chief Executive Officer |
| PAYMENT METHOD |
CC |
| FILING INFORMATION |
| SUBMIT DATE |
Mon Dec 05 17:43:31 EST 2005 |
| TEAS STAMP |
USPTO/S08N09-XXXXXXXXXX-2
0051205174331972159-13745
39-200678f752ce90cfa9af95
18de6ed695a7-CC-624-20051
205145123221497 |
| PTO Form 1963 (Rev 5/2006) |
| OMB No. 0651-0055 (Exp 10/31/2008) |
Combined Declaration of Use In Commerce & Application For Renewal of Registration of A Mark Under Sections 8 & 9
To the Commissioner for Trademarks:
REGISTRATION NUMBER: 1374539
REGISTRATION DATE: 12/10/1985
MARK: ETHAMOLIN
The owner, QOL Medical LLC, residing at 12419 198th Dr. NE, Woodinville, Washington United States 98077, is using the mark in commerce on or in connection with the goods and /or services as
follows:
For International Class 005, the owner is using or is using through a related company or licensee the mark in commerce on or in connection with all goods and/or services listed in the existing
registration.
The owner is submitting one specimen for each class showing the mark as used in commerce on or in connection with any item in the class of listed goods and/or services , consisting of a(n) product
packaging.
Specimen-1
The registrant hereby appoints Sarah A. Crain, Esq. and Stephen R. Baird, Troy E. Arnlund of Winthrop & Weinstine, P.A., Suite 3500, 225 South 6th Street, Minneapolis, Minnesota United
States 55402 to submit this Combined Declaration of Use In Commerce & Application For Renewal of Registration of A Mark Under Sections 8 & 9 on behalf of the registrant. The attorney
docket/reference number is 10718.
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 in Commerce
The owner is using or is using through a related company or licensee the mark in commerce on or in connection with the goods/services identified above, as evidenced by the attached specimen(s)
showing the mark as used in commerce.
Section 9: Application for Renewal
The registrant requests that the registration be renewed for the goods and/or services identified above.
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.
Signature: /T G Blake/ Date: 12/05/2005
Signatory's Name: Trevor G Blake
Signatory's Position: Chief Executive Officer
Mailing Address:
Winthrop & Weinstine, P.A.
Suite 3500
225 South 6th Street
Minneapolis, Minnesota 55402
RAM Sale Number: 624
RAM Accounting Date: 12/06/2005
Serial Number: 73520081
Internet Transmission Date: Mon Dec 05 17:43:31 EST 2005
TEAS Stamp: USPTO/S08N09-XXXXXXXXXX-2005120517433197
2159-1374539-200678f752ce90cfa9af9518de6
ed695a7-CC-624-20051205145123221497
