| PTO Form 1963 (Rev 5/2006) |
| OMB No. 0651-0055 (Exp 07/31/2018) |
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 |
2592940 |
| REGISTRATION DATE |
07/09/2002 |
| SERIAL NUMBER |
76278678 |
| MARK SECTION |
| MARK |
LSS |
| ATTORNEY SECTION (current) |
| NAME |
MARSHA STOLT |
| FIRM NAME |
MOSS & BARNETT, P.A. |
| INTERNAL ADDRESS |
4800 WELLS FARGO CENTER |
| STREET |
90 SOUTH SEVENTH STREET |
| CITY |
MINNEAPOLIS |
| STATE |
Minnesota |
| POSTAL CODE |
55402-4129 |
| COUNTRY |
United States |
| PHONE |
(612) 339-1863 |
| FAX |
(612) 339-6580 |
| ATTORNEY SECTION (proposed) |
| NAME |
MARSHA STOLT |
| FIRM NAME |
MOSS & BARNETT, P.A. |
| INTERNAL ADDRESS |
4800 WELLS FARGO CENTER |
| STREET |
90 SOUTH SEVENTH STREET |
| CITY |
MINNEAPOLIS |
| STATE |
Minnesota |
| POSTAL CODE |
55402-4129 |
| COUNTRY |
United States |
| PHONE |
612-877-5443 |
| FAX |
612-877-5999 |
| EMAIL |
ipmsd@moss-barnett.com |
| AUTHORIZED TO COMMUNICATE VIA E-MAIL |
Yes |
| DOCKET/REFERENCE NUMBER |
45038.7 |
| OTHER APPOINTED ATTORNEY |
Dave F. Senger and all of the firm of Moss & Barnett, P.A. |
| CORRESPONDENCE SECTION (current) |
| NAME |
MARSHA STOLT |
| FIRM NAME |
MOSS & BARNETT, P.A. |
| INTERNAL ADDRESS |
4800 WELLS FARGO CENTER |
| STREET |
90 SOUTH SEVENTH STREET |
| CITY |
MINNEAPOLIS |
| STATE |
Minnesota |
| POSTAL CODE |
55402-4129 |
| COUNTRY |
United States |
| PHONE |
(612) 339-1863 |
| FAX |
(612) 339-6580 |
| CORRESPONDENCE SECTION (proposed) |
| NAME |
MARSHA STOLT |
| FIRM NAME |
MOSS & BARNETT, P.A. |
| INTERNAL ADDRESS |
4800 WELLS FARGO CENTER |
| STREET |
90 SOUTH SEVENTH STREET |
| CITY |
MINNEAPOLIS |
| STATE |
Minnesota |
| POSTAL CODE |
55402-4129 |
| COUNTRY |
United States |
| PHONE |
612-877-5443 |
| FAX |
612-877-5999 |
| EMAIL |
ipmsd@moss-barnett.com |
| AUTHORIZED TO COMMUNICATE VIA E-MAIL |
Yes |
| DOCKET/REFERENCE NUMBER |
45038.7 |
| GOODS AND/OR SERVICES SECTION |
| INTERNATIONAL CLASS |
009 |
| GOODS OR SERVICES |
SOFTWARE FOR PHYSICIAN BILLING AND PRACTICE MANAGEMENT |
| SPECIMEN FILE NAME(S) |
| ORIGINAL PDF FILE |
SPN0-207250219194-102936709_._LSS.pdf |
CONVERTED PDF FILE(S)
(1 page) |
\\TICRS\EXPORT16\IMAGEOUT16\762\786\76278678\xml1\S890002.JPG |
| SPECIMEN DESCRIPTION |
screenshot of sign-on screen from Registrant's software program |
| OWNER SECTION (current) |
| NAME |
Lake Superior Software, Inc. |
| STREET |
6423 City West Parkway |
| CITY |
Eden Prairie |
| STATE |
Minnesota |
| ZIP/POSTAL CODE |
55344 |
| COUNTRY |
United States |
| LEGAL ENTITY SECTION (current) |
| TYPE |
corporation |
| STATE/COUNTRY OF INCORPORATION |
Minnesota |
| PAYMENT SECTION |
| NUMBER OF CLASSES |
1 |
| NUMBER OF CLASSES PAID |
1 |
| SUBTOTAL AMOUNT |
500 |
| TOTAL FEE PAID |
500 |
| SIGNATURE SECTION |
| SIGNATURE |
/ms/ |
| SIGNATORY'S NAME |
Marsha Stolt |
| SIGNATORY'S POSITION |
Attorney of record, Minnesota bar member |
| DATE SIGNED |
06/13/2012 |
| SIGNATORY'S PHONE NUMBER |
612-877-5443 |
| PAYMENT METHOD |
DA |
| FILING INFORMATION |
| SUBMIT DATE |
Wed Jun 13 11:10:29 EDT 2012 |
| TEAS STAMP |
USPTO/S08N09-XXX.XXX.XXX.
XXX-20120613111029935284-
2592940-490a83a7133fde84a
8c574bd383aaa9226-DA-9058
-20120613102936709528 |
| PTO Form 1963 (Rev 5/2006) |
| OMB No. 0651-0055 (Exp 07/31/2018) |
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: 2592940
REGISTRATION DATE: 07/09/2002
MARK: LSS
The owner, Lake Superior Software, Inc., DBA LSS Data Systems, a corporation of Minnesota, having an address of
6423 City West Parkway
Eden Prairie, Minnesota 55344
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/services, or to indicate membership in the collective membership organization, listed in the
existing registration for this specific class: SOFTWARE FOR PHYSICIAN BILLING AND PRACTICE MANAGEMENT ; or, the owner is making the listed excusable nonuse claim.
The owner is submitting one(or more) specimen(s) showing the mark as used in commerce on or in connection with any item in this class, consisting of a(n) screenshot of sign-on screen from
Registrant's software program.
Original PDF file:
SPN0-207250219194-102936709_._LSS.pdf
Converted PDF file(s) (1 page)
Specimen File1
The registrant's current Attorney Information: MARSHA STOLT of MOSS & BARNETT, P.A.
4800 WELLS FARGO CENTER
90 SOUTH SEVENTH STREET
MINNEAPOLIS, Minnesota (MN) 55402-4129
United States
The registrant's proposed Attorney Information: MARSHA STOLT of MOSS & BARNETT, P.A.
4800 WELLS FARGO CENTER
90 SOUTH SEVENTH STREET
MINNEAPOLIS, Minnesota (MN) 55402-4129
United States
The docket/reference number is 45038.7.
The Other Appointed Attorney(s): Dave F. Senger and all of the firm of Moss & Barnett, P.A..
The phone number is 612-877-5443.
The fax number is 612-877-5999.
The email address is ipmsd@moss-barnett.com.
The registrant's current Correspondence Information: MARSHA STOLT of MOSS & BARNETT, P.A.
4800 WELLS FARGO CENTER
90 SOUTH SEVENTH STREET
MINNEAPOLIS, Minnesota (MN) 55402-4129
United States
The registrant's proposed Correspondence Information: MARSHA STOLT of MOSS & BARNETT, P.A.
4800 WELLS FARGO CENTER
90 SOUTH SEVENTH STREET
MINNEAPOLIS, Minnesota (MN) 55402-4129
United States
The docket/reference number is 45038.7.
The phone number is 612-877-5443.
The fax number is 612-877-5999.
The email address is ipmsd@moss-barnett.com.
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 and/or Excusable Nonuse 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.
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.
Section 9: Application for Renewal
The registrant requests that the registration be renewed for the goods/services/collective organization identified above.
Signature: /ms/ Date: 06/13/2012
Signatory's Name: Marsha Stolt
Signatory's Position: Attorney of record, Minnesota bar member
Signatory's Phone Number: 612-877-5443
Mailing Address
(current):
MOSS & BARNETT, P.A.
90 SOUTH SEVENTH STREET
MINNEAPOLIS, Minnesota 55402-4129
Mailing Address
(proposed):
MOSS & BARNETT, P.A.
90 SOUTH SEVENTH STREET
MINNEAPOLIS, Minnesota 55402-4129
Serial Number: 76278678
Internet Transmission Date: Wed Jun 13 11:10:29 EDT 2012
TEAS Stamp: USPTO/S08N09-XXX.XXX.XXX.XXX-20120613111
029935284-2592940-490a83a7133fde84a8c574
bd383aaa9226-DA-9058-2012061310293670952
8
