Change of Address

POSITIVITY

Gallup, Inc.

Section 7 Request Form

Change Of Correspondence Address

The table below presents the data as entered.

Input Field	Entered
SERIAL NUMBER	76188463
LAW OFFICE ASSIGNED	LAW OFFICE 114
MARK SECTION
MARK	POSITIVITY
NEW CORRESPONDENCE ADDRESS
NEW ADDRESS
AUTHORIZED TO COMMUNICATE VIA E-MAIL	YES
SIGNATURE SECTION
SIGNATURE	/kla12728/
SIGNATORY NAME	Ken L Andersen
SIGNATORY DATE	12/16/2014
SIGNATORY POSITION	VP Law
SIGNATURE	/kla12728/
SIGNATORY NAME	Ken L Andersen
SIGNATORY DATE	12/16/2014
SIGNATORY POSITION	VP Law
AUTHORIZED SIGNATORY	YES
FILING INFORMATION SECTION
SUBMIT DATE	Tue Dec 16 12:13:12 EST 2014
TEAS STAMP	USPTO/S7R-XXX.XXX.XXX.XX- 20141216121312229914-2926 018-500b89ced1de241354f22 bc4686f7c4f32be4f181b42f7 9c87ba42daefbc3d3f4-CC-10 992-20141216121033405870

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