| 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 |
1789774 |
| REGISTRATION DATE |
08/24/1993 |
| SERIAL NUMBER |
74309515 |
| MARK SECTION |
| MARK |
HEALTH MART |
| OWNER SECTION (current) |
| NAME |
HEALTH MART SYSTEMS INC |
| STREET |
1220 SENLAC DR |
| CITY |
CARROLLTON |
| STATE |
TX |
| ZIP/POSTAL CODE |
75006 |
| COUNTRY |
US |
| OWNER SECTION (proposed) |
| NAME |
HEALTH MART SYSTEMS INC |
| STREET |
1220 SENLAC DR |
| CITY |
CARROLLTON |
| STATE |
TX |
| ZIP/POSTAL CODE |
75006 |
| COUNTRY |
US |
| EMAIL |
XXXX |
| GOODS AND/OR SERVICES SECTION |
| INTERNATIONAL CLASS |
042 |
| KEEP EXISTING GOODS AND/OR SERVICES |
YES |
| SPECIMEN FILE NAME(S) |
\\ticrs\EXPORT6\IMAGEOUT6 \743\095\74309515\xml1\S8 90002.JPG |
| SPECIMEN DESCRIPTION |
web page describing the services |
| PAYMENT SECTION |
| NUMBER OF CLASSES |
1 |
| NUMBER OF CLASSES PAID |
1 |
| SUBTOTAL AMOUNT |
500 |
| TOTAL AMOUNT |
500 |
| SIGNATURE SECTION |
| SIGNATURE |
/glenettebabb/ |
| SIGNATORY NAME |
Glenette Babb |
| SIGNATORY DATE |
08/25/2003 |
| SIGNATORY POSITION |
Assistant Secretary |
| FILING INFORMATION |
| SUBMIT DATE |
Mon Aug 25 14:38:40 EDT 2003 |
| TEAS STAMP |
USPTO/S08N09-XXXXXXXXXXX-
20030825143840371015-1789
774-200a446b6bc17cc10c256
fa7d1108b929DA1-200308251
43702151098 |
| 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: 1789774
REGISTRATION DATE: 08/24/1993
MARK: HEALTH MART
The owner, HEALTH MART SYSTEMS INC, residing at 1220 SENLAC DR , CARROLLTON, TX US 75006, is using the mark in commerce on or in connection with the goods and /or services as follows:
For International Class 042, the owner is using or is using through a related company 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) web page
describing the services.
Specimen-1
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 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: /glenettebabb/ Date: 08/25/2003
Signatory's Name: Glenette Babb
Signatory's Position: Assistant Secretary
RAM Sale Number: 1
RAM Accounting Date: 08/26/2003
Serial Number: 74309515
Internet Transmission Date: Mon Aug 25 14:38:40 EDT 2003
TEAS Stamp: USPTO/S08N09-XXXXXXXXXXX-200308251438403
71015-1789774-200a446b6bc17cc10c256fa7d1
108b929DA1-20030825143702151098
