| 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 |
2809938 |
| REGISTRATION DATE |
02/03/2004 |
| SERIAL NUMBER |
76442533 |
| MARK SECTION |
| MARK |
FOXY LADY |
| ATTORNEY SECTION (no change) |
| NAME |
Herbert L. Bello |
| FIRM NAME |
Law Offices of Herbert L. Bello |
| STREET |
ONE HOLLIS STREET |
| CITY |
WELLESLEY |
| STATE |
Massachusetts |
| POSTAL CODE |
02482 |
| COUNTRY |
United States |
| PHONE |
(781) 235-4457 |
| FAX |
(781) 235-6448 |
| DOCKET/REFERENCE NUMBER |
38051 |
| CORRESPONDENCE SECTION (no change) |
| NAME |
Herbert L. Bello |
| FIRM NAME |
Law Offices of Herbert L. Bello |
| STREET |
ONE HOLLIS STREET |
| CITY |
WELLESLEY |
| STATE |
Massachusetts |
| POSTAL CODE |
02482 |
| COUNTRY |
United States |
| PHONE |
(781) 235-4457 |
| FAX |
(781) 235-6448 |
| DOCKET/REFERENCE NUMBER |
38051 |
| GOODS AND/OR SERVICES SECTION |
| INTERNATIONAL CLASS |
041 |
| GOODS OR SERVICES |
Entertainment in the nature of live performances for an adult audience, namely, exotic dance performances |
| SPECIMEN FILE NAME(S) |
\\TICRS\EXPORT16\IMAGEOUT 16\764\425\76442533\xml1\ S890002.JPG |
| SPECIMEN DESCRIPTION |
advertisement |
| INTERNATIONAL CLASS |
043 |
| GOODS OR SERVICES |
restaurant services and bar services |
| SPECIMEN FILE NAME(S) |
\\TICRS\EXPORT16\IMAGEOUT 16\764\425\76442533\xml1\ S890003.JPG |
| |
\\TICRS\EXPORT16\IMAGEOUT 16\764\425\76442533\xml1\ S890004.JPG |
| SPECIMEN DESCRIPTION |
advertisement and menu |
| OWNER SECTION (current) |
| NAME |
Gullivers Tavern, Incorporated |
| STREET |
318 Chalkstone Avenue |
| CITY |
Providence |
| STATE |
Rhode Island |
| ZIP/POSTAL CODE |
02908 |
| COUNTRY |
United States |
| LEGAL ENTITY SECTION (current) |
| TYPE |
corporation |
| STATE/COUNTRY OF INCORPORATION |
Rhode Island |
| PAYMENT SECTION |
| NUMBER OF CLASSES |
2 |
| NUMBER OF CLASSES PAID |
2 |
| SUBTOTAL AMOUNT |
1000 |
| TOTAL FEE PAID |
1000 |
| SIGNATURE SECTION |
| SIGNATURE |
/Herbert L. Bello/ |
| SIGNATORY'S NAME |
Herbert L. Bello |
| SIGNATORY'S POSITION |
Attorney of record, Massachusetts bar member |
| DATE SIGNED |
01/30/2014 |
| SIGNATORY'S PHONE NUMBER |
38051 |
| PAYMENT METHOD |
CC |
| FILING INFORMATION |
| SUBMIT DATE |
Thu Jan 30 17:36:57 EST 2014 |
| TEAS STAMP |
USPTO/S08N09-XXX.XX.XX.XX
-20140130173657374070-280
9938-5009fe467ed2a8c703ad
857a8ca879d2bcb8f2684a6af
6486218881c98bee50b5-CC-4
394-20140130173011914190 |
| 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: 2809938
REGISTRATION DATE: 02/03/2004
MARK: FOXY LADY
The owner, Gullivers Tavern, Incorporated, a corporation of Rhode Island, having an address of
318 Chalkstone Avenue
Providence, Rhode Island 02908
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 041, 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: Entertainment in the nature of live performances for an adult audience, namely, exotic dance performances ; 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) advertisement.
Specimen File1
For International Class 043, 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: restaurant services and bar 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) advertisement and menu.
Specimen File1
Specimen File2
A fee payment in the amount of $1000 will be submitted with the form, representing payment for 2 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: /Herbert L. Bello/ Date: 01/30/2014
Signatory's Name: Herbert L. Bello
Signatory's Position: Attorney of record, Massachusetts bar member
Signatory's Phone Number: 38051
Mailing Address:
Law Offices of Herbert L. Bello
ONE HOLLIS STREET
WELLESLEY, Massachusetts 02482
Serial Number: 76442533
Internet Transmission Date: Thu Jan 30 17:36:57 EST 2014
TEAS Stamp: USPTO/S08N09-XXX.XX.XX.XX-20140130173657
374070-2809938-5009fe467ed2a8c703ad857a8
ca879d2bcb8f2684a6af6486218881c98bee50b5
-CC-4394-20140130173011914190
