| 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 |
2800989 |
| REGISTRATION DATE |
12/30/2003 |
| SERIAL NUMBER |
76358631 |
| MARK SECTION |
| MARK |
VITALITY STATUS |
| CORRESPONDENCE SECTION (current) |
| NAME |
Bruce A. Fox |
| FIRM NAME |
NEAL, GERBER & EISENBERG, LLP |
| INTERNAL ADDRESS |
2 N. LASALLE ST. |
| STREET |
SUITE 1700 |
| CITY |
CHICAGO |
| STATE |
Illinois |
| POSTAL CODE |
60602-3963 |
| COUNTRY |
United States |
| PHONE |
312-269-8000 |
| FAX |
312-269-1747 |
| CORRESPONDENCE SECTION (proposed) |
| NAME |
Bruce A. Fox |
| FIRM NAME |
Neal, Gerber & Eisenberg LLP |
| INTERNAL ADDRESS |
Suite 1700 |
| STREET |
Two North LaSalle Street |
| CITY |
CHICAGO |
| STATE |
Illinois |
| POSTAL CODE |
60602 |
| COUNTRY |
United States |
| PHONE |
312-269-8000 |
| EMAIL |
trademarks@ngelaw.com |
| AUTHORIZED TO COMMUNICATE VIA E-MAIL |
Yes |
| DOCKET/REFERENCE NUMBER |
020059-16T1 |
| GOODS AND/OR SERVICES SECTION |
| INTERNATIONAL CLASS |
036 |
| GOODS OR SERVICES |
Providing health insurance underwriting services |
| SPECIMEN FILE NAME(S) |
| ORIGINAL PDF FILE |
SPN0-50202393-130225266_._HumanaVitality-specimen.pdf |
CONVERTED PDF FILE(S)
(5 pages) |
\\TICRS\EXPORT16\IMAGEOUT16\763\586\76358631\xml2\S890002.JPG |
| |
\\TICRS\EXPORT16\IMAGEOUT16\763\586\76358631\xml2\S890003.JPG |
| |
\\TICRS\EXPORT16\IMAGEOUT16\763\586\76358631\xml2\S890004.JPG |
| |
\\TICRS\EXPORT16\IMAGEOUT16\763\586\76358631\xml2\S890005.JPG |
| |
\\TICRS\EXPORT16\IMAGEOUT16\763\586\76358631\xml2\S890006.JPG |
| SPECIMEN DESCRIPTION |
Screen-shot of website showing services. |
| OWNER SECTION (current) |
| NAME |
DESTINY HEALTH, INC. |
| STREET |
SUITE 2100 |
| CITY |
CHICAGO |
| STATE |
Illinois |
| ZIP/POSTAL CODE |
60606 |
| COUNTRY |
United States |
| OWNER SECTION (proposed) |
| NAME |
DESTINY HEALTH, INC. |
| INTERNAL ADDRESS |
SUITE 2100 |
| STREET |
200 West Monroe Street |
| CITY |
CHICAGO |
| STATE |
Illinois |
| ZIP/POSTAL CODE |
60606 |
| COUNTRY |
United States |
| PHONE |
312-269-8000 |
| EMAIL |
XXXX |
| AUTHORIZED TO COMMUNICATE VIA E-MAIL |
Yes |
| LEGAL ENTITY SECTION (current) |
| TYPE |
corporation |
| STATE/COUNTRY OF INCORPORATION |
Delaware |
| PAYMENT SECTION |
| NUMBER OF CLASSES |
1 |
| NUMBER OF CLASSES PAID |
1 |
| SUBTOTAL AMOUNT |
500 |
| TOTAL FEE PAID |
500 |
| SIGNATURE SECTION |
| SIGNATURE |
/Robert Mrizek/ |
| SIGNATORY'S NAME |
Robert Mrizek |
| SIGNATORY'S POSITION |
General Counsel |
| DATE SIGNED |
12/30/2013 |
| SIGNATORY'S PHONE NUMBER |
312-224-7207 |
| PAYMENT METHOD |
DA |
| FILING INFORMATION |
| SUBMIT DATE |
Mon Dec 30 16:00:35 EST 2013 |
| TEAS STAMP |
USPTO/S08N09-XX.XXX.XXX.X
X-20131230160035159527-28
00989-50043902b19b64a21ae
d234a71f1a7b8b2eeec2b4152
6a77cfc3913f589df8f2-DA-2
466-20131230150741470383 |
| 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: 2800989
REGISTRATION DATE: 12/30/2003
MARK: VITALITY STATUS
The owner, DESTINY HEALTH, INC., a corporation of Delaware, having an address of
SUITE 2100
200 West Monroe Street
CHICAGO, Illinois 60606
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 036, 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: Providing health insurance underwriting services ; 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) Screen-shot of website showing services..
Original PDF file:
SPN0-50202393-130225266_._HumanaVitality-specimen.pdf
Converted PDF file(s) (5 pages)
Specimen File1
Specimen File2
Specimen File3
Specimen File4
Specimen File5
The registrant's current Correspondence Information: Bruce A. Fox of NEAL, GERBER & EISENBERG, LLP
2 N. LASALLE ST.
SUITE 1700
CHICAGO, Illinois (IL) 60602-3963
United States
The registrant's proposed Correspondence Information: Bruce A. Fox of Neal, Gerber & Eisenberg LLP
Suite 1700
Two North LaSalle Street
CHICAGO, Illinois (IL) 60602
United States
The docket/reference number is 020059-16T1.
The phone number is 312-269-8000.
The email address is trademarks@ngelaw.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: /Robert Mrizek/ Date: 12/30/2013
Signatory's Name: Robert Mrizek
Signatory's Position: General Counsel
Signatory's Phone Number: 312-224-7207
Serial Number: 76358631
Internet Transmission Date: Mon Dec 30 16:00:35 EST 2013
TEAS Stamp: USPTO/S08N09-XX.XXX.XXX.XX-2013123016003
5159527-2800989-50043902b19b64a21aed234a
71f1a7b8b2eeec2b41526a77cfc3913f589df8f2
-DA-2466-20131230150741470383
