| PTO Form 2197 (Rev 09/2005) |
| OMB No. 0651-0056 (Exp 09/30/2011) |
| Input Field | Entered |
|---|---|
| SERIAL NUMBER | 76345509 |
| REGISTRATION NUMBER | 2618147 |
| LAW OFFICE ASSIGNED | LAW OFFICE 109 |
| MARK SECTION | |
| MARK | 1-800-SMOKING |
| OWNER SECTION (current) | |
| NAME | Pinzon, Brian W. |
| STREET | P.O. Box 959 |
| CITY | Santa Teresa |
| STATE | New Mexico |
| ZIP/POSTAL CODE | 88008 |
| COUNTRY | US |
| CORRESPONDENCE SECTION (current) | |
| ORIGINAL ADDRESS | Curtis L. Harrington Brian Pinzon 705 Cervantes Court 705 Cervantes Court El Paso Texas 79922 United States 915-760-4776 915-592-8680 bpinzon@elp.rr.com |
| NEW OWNER ADDRESS | |
| STREET | 1751 High Point Circle |
| CITY | Black Hawk |
| STATE | Colorado |
| ZIP/POSTAL CODE | 80422 |
| COUNTRY | United States |
| PHONE | 303-582-3064 |
| NEW CORRESPONDENCE ADDRESS FOR OWNER | |
| NAME | Tish Masslich |
| INTERNAL ADDRESS | 1751 High Point circle |
| STREET | 1751 High Point Circle |
| CITY | Black Hawk |
| STATE | Colorado |
| COUNTRY | United States |
| POSTAL/ZIP CODE | 80422 |
| PHONE | 303-582-3064 |
| FAX | 303-582-3064 |
| SIGNATURE SECTION | |
| SIGNATURE | /Tish Masslich/ |
| SIGNATORY NAME | Tish Masslich |
| SIGNATORY DATE | 01/10/2010 |
| SIGNATORY POSITION | Owner |
| FILING INFORMATION SECTION | |
| SUBMIT DATE | Sun Jan 10 07:57:12 EST 2010 |
| TEAS STAMP | USPTO/COA-XX.XXX.XXX.XX-2 0100110075712814690-76345 509-4609077d902a6ca277c5b fb8f711cb604f-N/A-N/A-201 00110075216668220 |