PTO Form 1963 (Rev 5/2006) |
OMB No. 0651-0055 (Exp 12/31/2011) |
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 |
1645853 |
REGISTRATION DATE |
05/28/1991 |
SERIAL NUMBER |
74019088 |
MARK SECTION |
MARK |
IHSA |
CORRESPONDENCE SECTION (current) |
NAME |
SCOTT A. ANDRESEN |
FIRM NAME |
ANDRESEN & ASSOCIATES, P.C. |
INTERNAL ADDRESS |
3025 NORTH CALIFORNIA AVENUE |
STREET |
SUITE 4 S.E. |
CITY |
CHICAGO |
STATE |
Illinois |
POSTAL CODE |
60618-7009 |
COUNTRY |
United States |
PHONE |
(773) 572-6049 |
FAX |
(773) 572-6048 |
EMAIL |
Scott@AndresenLawFirm.com |
AUTHORIZED TO COMMUNICATE VIA E-MAIL |
Yes |
CORRESPONDENCE SECTION (proposed) |
NAME |
SCOTT A. ANDRESEN |
FIRM NAME |
ANDRESEN & ASSOCIATES, P.C. |
STREET |
3025 North California Avenue, Ste 4 S.E. |
CITY |
CHICAGO |
STATE |
Illinois |
POSTAL CODE |
60618-7009 |
COUNTRY |
United States |
PHONE |
(773) 572-6049 |
FAX |
(773) 572-6048 |
EMAIL |
Scott@AndresenLawFirm.com |
AUTHORIZED TO COMMUNICATE VIA E-MAIL |
Yes |
DOCKET/REFERENCE NUMBER |
IHSA-008 |
GOODS AND/OR SERVICES SECTION |
INTERNATIONAL CLASS |
009 |
GOODS OR SERVICES |
pre-recorded video tapes featuring interscholastic activities and programs |
SPECIMEN FILE NAME(S) |
\\TICRS\EXPORT11\IMAGEOUT 11\740\190\74019088\xml2\ S890002.JPG |
SPECIMEN DESCRIPTION |
Photo of a video box bearing the registered mark |
INTERNATIONAL CLASS |
016 |
GOODS OR SERVICES |
calendars, programs, folders, handbooks and magazines related to interscholastic activities |
SPECIMEN FILE NAME(S) |
\\TICRS\EXPORT11\IMAGEOUT 11\740\190\74019088\xml2\ S890003.JPG |
SPECIMEN DESCRIPTION |
Photo of a magazine related to interscholastic activities bearing the registered mark |
INTERNATIONAL CLASS |
021 |
GOODS OR SERVICES |
cups and mugs |
SPECIMEN FILE NAME(S) |
\\TICRS\EXPORT11\IMAGEOUT 11\740\190\74019088\xml2\ S890004.JPG |
SPECIMEN DESCRIPTION |
Photo of a mug bearing the registered mark |
INTERNATIONAL CLASS |
025 |
GOODS OR SERVICES |
clothing, namely shirts and sweatshirts |
SPECIMEN FILE NAME(S) |
\\TICRS\EXPORT11\IMAGEOUT 11\740\190\74019088\xml2\ S890005.JPG |
SPECIMEN DESCRIPTION |
Photo of an employee/staff shirt bearing the registered mark as a source of origin |
INTERNATIONAL CLASS |
041 |
GOODS OR SERVICES |
sanctioning, supervising, and regulating interscholastic activities and programs |
SPECIMEN FILE NAME(S) |
\\TICRS\EXPORT11\IMAGEOUT 11\740\190\74019088\xml2\ S890006.JPG |
SPECIMEN DESCRIPTION |
Screen capture of Registrant's informational and promotional website bearing the registered mark |
OWNER SECTION (current) |
NAME |
Illinois High School Association |
CITY |
Bloomington |
STATE |
Illinois |
ZIP/POSTAL CODE |
61702-2715 |
COUNTRY |
United States |
OWNER SECTION (proposed) |
NAME |
Illinois High School Association |
STREET |
2715 McGraw Drive |
CITY |
Bloomington |
STATE |
Illinois |
ZIP/POSTAL CODE |
61704 |
COUNTRY |
United States |
LEGAL ENTITY SECTION (current) |
TYPE |
NOT-FOR-PROFIT ASSOCIATION |
STATE/COUNTRY WHERE LEGALLY ORGANIZED |
Illinois |
LEGAL ENTITY SECTION (proposed) |
TYPE |
NOT-FOR-PROFIT ASSOCIATION |
STATE/COUNTRY WHERE LEGALLY ORGANIZED |
Illinois |
PAYMENT SECTION |
NUMBER OF CLASSES |
5 |
NUMBER OF CLASSES PAID |
5 |
SUBTOTAL AMOUNT |
2500 |
TOTAL FEE PAID |
2500 |
SIGNATURE SECTION |
SIGNATURE |
/Scott A. Andresen/ |
SIGNATORY'S NAME |
Scott A. Andresen |
SIGNATORY'S POSITION |
Attorney of Record, Illinois bar member |
DATE SIGNED |
04/18/2011 |
PAYMENT METHOD |
CC |
FILING INFORMATION |
SUBMIT DATE |
Mon Apr 18 18:57:39 EDT 2011 |
TEAS STAMP |
USPTO/S08N09-XX.XXX.XXX.X
XX-20110418185739685220-1
645853-480bc8df62625f8551
38754c8834cbb2287-CC-5195
-20110418184048280617 |
PTO Form 1963 (Rev 5/2006) |
OMB No. 0651-0055 (Exp 12/31/2011) |
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: 1645853
REGISTRATION DATE: 05/28/1991
MARK: IHSA
The owner, Illinois High School Association, NOT-FOR-PROFIT ASSOCIATION legally organized under the laws of Illinois, having an address of
2715 McGraw Drive
Bloomington, Illinois 61704
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 International Class 009, the mark is in use in commerce on or in connection with
all goods or services listed in the existing registration for this specific class: pre-recorded video tapes
featuring interscholastic activities and programs ; or, the owner is making the listed excusable nonuse claim.
The owner is submitting one specimen showing the mark as used in commerce on or in connection with any item in this class, consisting of a(n) Photo of a video box bearing the registered mark.
Specimen File1
For International Class 016, the mark is in use in commerce on or in connection with
all goods or services listed in the existing registration for this specific class: calendars, programs,
folders, handbooks and magazines related to interscholastic activities ; or, the owner is making the listed excusable nonuse claim.
The owner is submitting one specimen showing the mark as used in commerce on or in connection with any item in this class, consisting of a(n) Photo of a magazine related to interscholastic activities
bearing the registered mark.
Specimen File1
For International Class 021, the mark is in use in commerce on or in connection with
all goods or services listed in the existing registration for this specific class: cups and mugs ; or, the
owner is making the listed excusable nonuse claim.
The owner is submitting one specimen showing the mark as used in commerce on or in connection with any item in this class, consisting of a(n) Photo of a mug bearing the registered mark.
Specimen File1
For International Class 025, the mark is in use in commerce on or in connection with
all goods or services listed in the existing registration for this specific class: clothing, namely shirts
and sweatshirts ; or, the owner is making the listed excusable nonuse claim.
The owner is submitting one specimen showing the mark as used in commerce on or in connection with any item in this class, consisting of a(n) Photo of an employee/staff shirt bearing the registered
mark as a source of origin.
Specimen File1
For International Class 041, the mark is in use in commerce on or in connection with
all goods or services listed in the existing registration for this specific class: sanctioning,
supervising, and regulating interscholastic activities and programs ; or, the owner is making the listed excusable nonuse claim.
The owner is submitting one specimen showing the mark as used in commerce on or in connection with any item in this class, consisting of a(n) Screen capture of Registrant's informational and
promotional website bearing the registered mark.
Specimen File1
The registrant's current Correspondence Information: SCOTT A. ANDRESEN of ANDRESEN & ASSOCIATES, P.C.
3025 NORTH CALIFORNIA AVENUE
SUITE 4 S.E.
CHICAGO, Illinois (IL) 60618-7009
United States (USX)
The registrant's proposed Correspondence Information: SCOTT A. ANDRESEN of ANDRESEN & ASSOCIATES, P.C.
3025 North California Avenue, Ste 4 S.E.
CHICAGO, Illinois (IL) 60618-7009
United States (USX)
The docket/reference number is IHSA-008.
The phone number is (773) 572-6049.
The fax number is (773) 572-6048.
The email address is Scott@AndresenLawFirm.com.
A fee payment in the amount of $2500 will be submitted with the form, representing payment for 5 class(es), plus any additional grace period fee, if necessary.
Declaration
Section 8: Declaration of Use 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.
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: /Scott A. Andresen/ Date: 04/18/2011
Signatory's Name: Scott A. Andresen
Signatory's Position: Attorney of Record, Illinois bar member
Serial Number: 74019088
Internet Transmission Date: Mon Apr 18 18:57:39 EDT 2011
TEAS Stamp: USPTO/S08N09-XX.XXX.XXX.XXX-201104181857
39685220-1645853-480bc8df62625f855138754
c8834cbb2287-CC-5195-2011041818404828061
7