Change of Address

INPUT

Gallup, Inc.

Section 7 Request Form

Change Of Correspondence Address


The table below presents the data as entered.

Input Field Entered
SERIAL NUMBER 76188467
LAW OFFICE ASSIGNED LAW OFFICE 113
MARK SECTION
MARK INPUT
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 12:19:49 EST 2014
TEAS STAMP USPTO/S7R-XXX.XXX.XXX.XX-
20141216121949301940-2946
849-50063453bc8284ec1d194
912a3283a6592f359254bf767
8a663aac97ff1cbdfc9f-CC-1
1085-20141216121730714455




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