| 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 |
2631479 |
| REGISTRATION DATE |
10/08/2002 |
| SERIAL NUMBER |
76347478 |
| MARK SECTION |
| MARK |
IDEAL BREAST |
| ATTORNEY SECTION (current) |
| NAME |
STEPHEN L. ANDERSON |
| FIRM NAME |
ANDERSON & ASSOCIATES |
| INTERNAL ADDRESS |
SUITE 208 |
| STREET |
32605 TEMECULA PARKWAY |
| CITY |
TEMECULA |
| STATE |
California |
| POSTAL CODE |
92592 |
| COUNTRY |
United States |
| PHONE |
951-694-1877 |
| FAX |
951-694-1876 |
| EMAIL |
attorneys@brandxperts.com |
| AUTHORIZED TO COMMUNICATE VIA E-MAIL |
Yes |
| ATTORNEY SECTION (proposed) |
| NAME |
STEPHEN L. ANDERSON |
| FIRM NAME |
ANDERSON & ASSOCIATES |
| STREET |
27247 Madison Ave., Ste 121 |
| CITY |
TEMECULA |
| STATE |
California |
| POSTAL CODE |
92590 |
| COUNTRY |
United States |
| PHONE |
951-296-1700 |
| FAX |
951-296-2456 |
| EMAIL |
attorneys@brandxperts.com |
| AUTHORIZED TO COMMUNICATE VIA E-MAIL |
Yes |
| CORRESPONDENCE SECTION (current) |
| NAME |
STEPHEN L. ANDERSON |
| FIRM NAME |
ANDERSON & ASSOCIATES |
| INTERNAL ADDRESS |
SUITE 208 |
| STREET |
32605 TEMECULA PARKWAY |
| CITY |
TEMECULA |
| STATE |
California |
| POSTAL CODE |
92592 |
| COUNTRY |
United States |
| PHONE |
951-694-1877 |
| FAX |
951-694-1876 |
| EMAIL |
attorneys@brandxperts.com |
| AUTHORIZED TO COMMUNICATE VIA E-MAIL |
Yes |
| CORRESPONDENCE SECTION (proposed) |
| NAME |
STEPHEN L. ANDERSON |
| FIRM NAME |
ANDERSON & ASSOCIATES |
| STREET |
27247 Madison Ave., Ste 121 |
| CITY |
TEMECULA |
| STATE |
California |
| POSTAL CODE |
92590 |
| COUNTRY |
United States |
| PHONE |
951-296-1700 |
| FAX |
951-296-2456 |
| EMAIL |
attorneys@brandxperts.com |
| AUTHORIZED TO COMMUNICATE VIA E-MAIL |
Yes |
| GOODS AND/OR SERVICES SECTION |
| INTERNATIONAL CLASS |
042 |
| GOODS OR SERVICES |
medical services, namely, cosmetic and reconstructive surgery, laser skin resurfacing, laser hair removal, liposuction, and dietary and
nutrition counseling |
| SPECIMEN FILE NAME(S) |
\\TICRS\EXPORT16\IMAGEOUT 16\763\474\76347478\xml1\ S890002.JPG |
| |
\\TICRS\EXPORT16\IMAGEOUT 16\763\474\76347478\xml1\ S890003.JPG |
| SPECIMEN DESCRIPTION |
screenshots from the Registrant's website showing the mark in use in connection with the services. |
| OWNER SECTION (current) |
| NAME |
Swanson, Eric |
| STREET |
11413 Ash Drive |
| CITY |
Leawood |
| STATE |
Kansas |
| ZIP/POSTAL CODE |
66211 |
| COUNTRY |
United States |
| PHONE |
(913) 663-1030 |
| FAX |
(913) 663-1032 |
| EMAIL |
XXXX |
| LEGAL ENTITY SECTION (current) |
| TYPE |
individual |
| COUNTRY OF CITIZENSHIP |
United States |
| PAYMENT SECTION |
| NUMBER OF CLASSES |
1 |
| NUMBER OF CLASSES PAID |
1 |
| SUBTOTAL AMOUNT |
500 |
| TOTAL FEE PAID |
500 |
| SIGNATURE SECTION |
| SIGNATURE |
/StephenLAnderson/ |
| SIGNATORY'S NAME |
Stephen L. Anderson |
| SIGNATORY'S POSITION |
Attorney for Registrant - CA Bar Member |
| DATE SIGNED |
07/26/2012 |
| SIGNATORY'S PHONE NUMBER |
951-296-1700 |
| PAYMENT METHOD |
CC |
| FILING INFORMATION |
| SUBMIT DATE |
Thu Jul 26 19:52:27 EDT 2012 |
| TEAS STAMP |
USPTO/S08N09-XX.XXX.XXX.X
-20120726195227388612-263
1479-49070abb04327965885e
ddb6f9fcb13e33-CC-7030-20
120726194731146896 |
| 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: 2631479
REGISTRATION DATE: 10/08/2002
MARK: IDEAL BREAST
The owner, Eric Swanson, a citizen of United States, having an address of
11413 Ash Drive
Leawood, Kansas 66211
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 042, 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: medical services, namely, cosmetic and reconstructive surgery, laser skin resurfacing, laser hair removal, liposuction, and dietary and nutrition
counseling ; 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) screenshots from the Registrant's website
showing the mark in use in connection with the services..
Specimen File1
Specimen File2
The registrant's current Attorney Information: STEPHEN L. ANDERSON of ANDERSON & ASSOCIATES
SUITE 208
32605 TEMECULA PARKWAY
TEMECULA, California (CA) 92592
United States
The registrant's proposed Attorney Information: STEPHEN L. ANDERSON of ANDERSON & ASSOCIATES
27247 Madison Ave., Ste 121
TEMECULA, California (CA) 92590
United States
The phone number is 951-296-1700.
The fax number is 951-296-2456.
The email address is attorneys@brandxperts.com.
The registrant's current Correspondence Information: STEPHEN L. ANDERSON of ANDERSON & ASSOCIATES
SUITE 208
32605 TEMECULA PARKWAY
TEMECULA, California (CA) 92592
United States
The registrant's proposed Correspondence Information: STEPHEN L. ANDERSON of ANDERSON & ASSOCIATES
27247 Madison Ave., Ste 121
TEMECULA, California (CA) 92590
United States
The phone number is 951-296-1700.
The fax number is 951-296-2456.
The email address is attorneys@brandxperts.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: /StephenLAnderson/ Date: 07/26/2012
Signatory's Name: Stephen L. Anderson
Signatory's Position: Attorney for Registrant - CA Bar Member
Signatory's Phone Number: 951-296-1700
Mailing Address
(current):
ANDERSON & ASSOCIATES
32605 TEMECULA PARKWAY
TEMECULA, California 92592
Mailing Address
(proposed):
ANDERSON & ASSOCIATES
27247 Madison Ave., Ste 121
TEMECULA, California 92590
Serial Number: 76347478
Internet Transmission Date: Thu Jul 26 19:52:27 EDT 2012
TEAS Stamp: USPTO/S08N09-XX.XXX.XXX.X-20120726195227
388612-2631479-49070abb04327965885eddb6f
9fcb13e33-CC-7030-20120726194731146896
