| 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 |
2677890 |
| REGISTRATION DATE |
01/21/2003 |
| SERIAL NUMBER |
76398815 |
| MARK SECTION |
| MARK |
BRACE |
| ATTORNEY SECTION (current) |
| NAME |
WILLIAM J. MASON, ESQ. |
| FIRM NAME |
MACCORD MASON PLLC |
| STREET |
POST OFFICE BOX 1489 |
| CITY |
WRIGHTSVILLE BEACH |
| STATE |
North Carolina |
| POSTAL CODE |
28480 |
| COUNTRY |
United States |
| PHONE |
(910) 313-6175 |
| EMAIL |
lquinn@mmpatent.com |
| AUTHORIZED TO COMMUNICATE VIA E-MAIL |
Yes |
| ATTORNEY SECTION (proposed) |
| NAME |
WILLIAM J. MASON, ESQ. |
| FIRM NAME |
MACCORD MASON PLLC |
| STREET |
POST OFFICE BOX 1489 |
| CITY |
WRIGHTSVILLE BEACH |
| STATE |
North Carolina |
| POSTAL CODE |
28480 |
| COUNTRY |
United States |
| PHONE |
(910) 313-6175 |
| FAX |
910 313 6178 |
| EMAIL |
lquinn@mmpatent.com |
| AUTHORIZED TO COMMUNICATE VIA E-MAIL |
Yes |
| DOCKET/REFERENCE NUMBER |
5601-003 |
| CORRESPONDENCE SECTION (current) |
| NAME |
WILLIAM J. MASON, ESQ. |
| FIRM NAME |
MACCORD MASON PLLC |
| STREET |
POST OFFICE BOX 1489 |
| CITY |
WRIGHTSVILLE BEACH |
| STATE |
North Carolina |
| POSTAL CODE |
28480 |
| COUNTRY |
United States |
| PHONE |
(910) 313-6175 |
| EMAIL |
lquinn@mmpatent.com |
| AUTHORIZED TO COMMUNICATE VIA E-MAIL |
Yes |
| CORRESPONDENCE SECTION (proposed) |
| NAME |
WILLIAM J. MASON, ESQ. |
| FIRM NAME |
MACCORD MASON PLLC |
| STREET |
POST OFFICE BOX 1489 |
| CITY |
WRIGHTSVILLE BEACH |
| STATE |
North Carolina |
| POSTAL CODE |
28480 |
| COUNTRY |
United States |
| PHONE |
(910) 313-6175 |
| FAX |
910 313 6178 |
| EMAIL |
lquinn@mmpatent.com |
| AUTHORIZED TO COMMUNICATE VIA E-MAIL |
Yes |
| DOCKET/REFERENCE NUMBER |
5601-003 |
| GOODS AND/OR SERVICES SECTION |
| INTERNATIONAL CLASS |
044 |
| GOODS OR SERVICES |
PSYCHIATRIC SERVICES, NAMELY, PSYCHOLOGICAL CONSULTING, TESTING, PROFILING AND THERAPY |
| SPECIMEN FILE NAME(S) |
| ORIGINAL PDF FILE |
SPN0-7063205140-110708810_._5601-003_specimen.pdf |
CONVERTED PDF FILE(S)
(1 page) |
\\TICRS\EXPORT16\IMAGEOUT16\763\988\76398815\xml1\S890002.JPG |
| SPECIMEN DESCRIPTION |
website page |
| OWNER SECTION (current) |
| NAME |
SMITH, RUSSELL L, MR. |
| STREET |
5304 DAWNING CREEK WAY |
| CITY |
WILMINGTON |
| STATE |
North Carolina |
| ZIP/POSTAL CODE |
28409 |
| COUNTRY |
United States |
| 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 |
/William J Mason/ |
| SIGNATORY'S NAME |
William J. Mason |
| SIGNATORY'S POSITION |
Attorney of record |
| DATE SIGNED |
12/06/2012 |
| SIGNATORY'S PHONE NUMBER |
910-313-6175 |
| PAYMENT METHOD |
CC |
| FILING INFORMATION |
| SUBMIT DATE |
Thu Dec 06 11:14:27 EST 2012 |
| TEAS STAMP |
USPTO/S08N09-XX.XX.XXX.XX
X-20121206111427911794-26
77890-49065249653f26ae7e8
1cf0fdc305e88dd-CC-10199-
20121206110708810644 |
| 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: 2677890
REGISTRATION DATE: 01/21/2003
MARK: BRACE
The owner, RUSSELL L, MR SMITH, a citizen of United States, having an address of
5304 DAWNING CREEK WAY
WILMINGTON, North Carolina 28409
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 044, 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: PSYCHIATRIC SERVICES, NAMELY, PSYCHOLOGICAL CONSULTING, TESTING, PROFILING AND THERAPY ; 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) website page.
Original PDF file:
SPN0-7063205140-110708810_._5601-003_specimen.pdf
Converted PDF file(s) (1 page)
Specimen File1
The registrant's current Attorney Information: WILLIAM J. MASON, ESQ. of MACCORD MASON PLLC
POST OFFICE BOX 1489
WRIGHTSVILLE BEACH, North Carolina (NC) 28480
United States
The registrant's proposed Attorney Information: WILLIAM J. MASON, ESQ. of MACCORD MASON PLLC
POST OFFICE BOX 1489
WRIGHTSVILLE BEACH, North Carolina (NC) 28480
United States
The docket/reference number is 5601-003.
The phone number is (910) 313-6175.
The fax number is 910 313 6178.
The email address is lquinn@mmpatent.com.
The registrant's current Correspondence Information: WILLIAM J. MASON, ESQ. of MACCORD MASON PLLC
POST OFFICE BOX 1489
WRIGHTSVILLE BEACH, North Carolina (NC) 28480
United States
The registrant's proposed Correspondence Information: WILLIAM J. MASON, ESQ. of MACCORD MASON PLLC
POST OFFICE BOX 1489
WRIGHTSVILLE BEACH, North Carolina (NC) 28480
United States
The docket/reference number is 5601-003.
The phone number is (910) 313-6175.
The fax number is 910 313 6178.
The email address is lquinn@mmpatent.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: /William J Mason/ Date: 12/06/2012
Signatory's Name: William J. Mason
Signatory's Position: Attorney of record
Signatory's Phone Number: 910-313-6175
Mailing Address
(current):
MACCORD MASON PLLC
POST OFFICE BOX 1489
WRIGHTSVILLE BEACH, North Carolina 28480
Mailing Address
(proposed):
MACCORD MASON PLLC
POST OFFICE BOX 1489
WRIGHTSVILLE BEACH, North Carolina 28480
Serial Number: 76398815
Internet Transmission Date: Thu Dec 06 11:14:27 EST 2012
TEAS Stamp: USPTO/S08N09-XX.XX.XXX.XXX-2012120611142
7911794-2677890-49065249653f26ae7e81cf0f
dc305e88dd-CC-10199-20121206110708810644
