| PTO Form 1597 (Rev 11/2007) |
| OMB No. 0651-0055 (Exp. 12/31/2011) |
Section 7 Request Form
The table below presents the data as entered.
Input Field
|
Entered
|
| REGISTRATION NUMBER |
2800989 |
| LAW OFFICE ASSIGNED |
LAW OFFICE 103 |
| SERIAL NUMBER |
76358631 |
| MARK SECTION (current) |
| STANDARD CHARACTERS |
YES |
| USPTO-GENERATED IMAGE |
YES |
| LITERAL ELEMENT |
VITALITY STATUS |
| MARK STATEMENT |
The mark consists of standard characters, without claim to any particular font style, size or color. |
| OWNER SECTION (current) |
| NAME |
DESTINY HEALTH, INC. |
| STREET |
6430 Rockledge Drive Suite 602 |
| CITY |
BETHESDA |
| STATE |
Maryland |
| ZIP/POSTAL CODE |
20817 |
| COUNTRY |
United States |
| OWNER SECTION (proposed) |
| NAME |
DESTINY HEALTH, INC. |
| INTERNAL ADDRESS |
Suite 2100 |
| STREET |
200 West Monroe St. |
| CITY |
Chicago |
| STATE |
Illinois |
| ZIP/POSTAL CODE |
60606 |
| COUNTRY |
United States |
| PHONE |
312-224-7100 |
| FAX |
312-224-7101 |
| LEGAL ENTITY SECTION (current) |
| TYPE |
corporation |
| STATE/COUNTRY OF INCORPORATION |
Maryland |
| LEGAL ENTITY SECTION (proposed) |
| TYPE |
corporation |
| STATE/COUNTRY OF INCORPORATION |
Delaware |
| ADDITIONAL STATEMENTS SECTION |
| MISCELLANEOUS STATEMENT |
A change in the owner's state of incorporation from Maryland to Delaware is requested. This change is being requested due to a good faith
filer error. A new certificate is being requested. |
| PAYMENT SECTION |
| TOTAL AMOUNT |
100 |
| TOTAL FEES DUE |
100 |
| SIGNATURE SECTION |
| DECLARATION SIGNATURE |
/Robert J. Mrizek/ |
| SIGNATORY'S NAME |
Robert J. Mrizek |
| SIGNATORY'S POSITION |
General Counsel and Secretary |
| DATE SIGNED |
11/19/2008 |
| REQUEST SIGNATURE |
/Robert J. Mrizek/ |
| SIGNATORY'S NAME |
Robert J. Mrizek |
| SIGNATORY'S POSITION |
General Counsel and Secretary |
| DATE SIGNED |
11/19/2008 |
| AUTHORIZED SIGNATORY |
YES |
| CONCURRENT § 8, 8 &15, OR 8 &9 FILED |
NO |
| FILING INFORMATION SECTION |
| SUBMIT DATE |
Wed Nov 19 16:55:24 EST 2008 |
| TEAS STAMP |
USPTO/S7R-XXX.XXX.XXX.XX-
20081119165524065827-2800
989-43012e7255663a71cf691
f7121375ac47e1-DA-2402-20
081119162724473788 |
| PTO Form 1597 (Rev 11/2007) |
| OMB No. 0651-0055 (Exp. 12/31/2011) |
Section 7 Request Form
To the Commissioner for Trademarks:
The registrant requests the following amendment(s) to registration no.
2800989 VITALITY STATUS
OWNER AND/OR ENTITY INFORMATION
Registrant proposes to amend the following:
Current: DESTINY HEALTH, INC., a corporation of Maryland, having an address of
6430 Rockledge Drive Suite 602
BETHESDA, Maryland 20817
United States
Proposed: DESTINY HEALTH, INC., a corporation of Delaware, having an address of
Suite 2100
200 West Monroe St.
Chicago, Illinois 60606
United States
312-224-7100
312-224-7101
ADDITIONAL STATEMENTS
Miscellaneous Statement(s)
A change in the owner's state of incorporation from Maryland to Delaware is requested. This change is being requested due to a good faith filer error. A new certificate is being requested.
FEE(S)
Fee(s) in the amount of $100 is being submitted.
SIGNATURE(S)
Declaration Signature
The undersigned, being hereby warned that willful false statements and the like so made are punishable by fine or imprisonment, or both, under 18 U.S.C. §1001, and that such willful false statements
may jeopardize the validity of the application or document or any resulting registration, declares that all statements made of his/her own knowledge are true; and all statements made on information
and belief are believed to be true.
Signature: /Robert J. Mrizek/ Date: 11/19/2008
Signatory's Name: Robert J. Mrizek
Signatory's Position: General Counsel and Secretary
Request Signature
Signature: /Robert J. Mrizek/ Date: 11/19/2008
Signatory's Name: Robert J. Mrizek
Signatory's Position: General Counsel and Secretary
The signatory has confirmed that he/she is not represented by either an authorized attorney or Canadian attorney/agent, and that he/she is either (1) the registrant or (2) a person(s) with legal
authority to bind the registrant; and if an authorized U.S. attorney or Canadian attorney/agent previously represented him/her in this matter, either he/she has filed a signed revocation of power of
attorney with the USPTO or the USPTO has granted the request of his/her prior representative to withdraw.
The applicant is NOT filing a Declaration of Use of Mark under Section 8; a Combined Declaration of Use of Mark under Sections 8 & 15; or a Combined Declaration of Use of Mark/Application for
Renewal of Registration of Mark under Sections 8 & 9 in conjunction with this Section 7 Request.
RAM Sale Number: 2402
RAM Accounting Date: 11/20/2008
Serial Number: 76358631
Internet Transmission Date: Wed Nov 19 16:55:24 EST 2008
TEAS Stamp: USPTO/S7R-XXX.XXX.XXX.XX-200811191655240
65827-2800989-43012e7255663a71cf691f7121
375ac47e1-DA-2402-20081119162724473788