| PTO Form 1553 (Rev 5/2006) |
| OMB No. 0651-0055 (Exp 12/31/2011) |
Declaration of Use and/or Excusable Nonuse of Mark in Commerce under Section 8
The table below presents the data as entered.
Input Field
|
Entered
|
| REGISTRATION NUMBER |
2969190 |
| REGISTRATION DATE |
07/19/2005 |
| SERIAL NUMBER |
76510098 |
| MARK SECTION |
| MARK |
MEDSOURCE (stylized and/or with design) |
| CORRESPONDENCE SECTION (current) |
| NAME |
WOODROW W. BAN |
| FIRM NAME |
1550 STONINGTON |
| CITY |
HUDSON |
| STATE |
Ohio |
| POSTAL CODE |
44236-1237 |
| COUNTRY |
United States |
| CORRESPONDENCE SECTION (proposed) |
| NAME |
PASCALE, DAWN |
| STREET |
300 MAIN ST. - 7TH FL. |
| CITY |
STAMFORD |
| STATE |
Connecticut |
| POSTAL CODE |
06901 |
| COUNTRY |
United States |
| PHONE |
800-575-2880 |
| FAX |
203-324-0555 |
| EMAIL |
dpascale@medsourceconsultants.com |
| AUTHORIZED TO COMMUNICATE VIA E-MAIL |
Yes |
| GOODS AND/OR SERVICES SECTION |
| INTERNATIONAL CLASS |
035 |
| GOODS OR SERVICES |
Consulting services to the legal profession, namely, locating experts in the fields of medicine, nursing and allied health fields to review
medical, render oral and/or written opinions and testimony |
| SPECIMEN FILE NAME(S) |
| ORIGINAL PDF FILE |
SPN0-759922926-141604615_._MEDSOURCE_10001.PDF |
CONVERTED PDF FILE(S)
(1 page) |
\\TICRS\EXPORT11\IMAGEOUT11\765\100\76510098\xml3\S080002.JPG |
| SPECIMEN DESCRIPTION |
scanned website page |
| OWNER SECTION (current) |
| NAME |
PASCALE, DAWN |
| STREET |
300 MAIN ST. - 7TH FL. |
| CITY |
STAMFORD |
| STATE |
Connecticut |
| ZIP/POSTAL CODE |
06901 |
| COUNTRY |
United States |
| OWNER SECTION (proposed) |
| NAME |
PASCALE, DAWN |
| STREET |
300 MAIN ST. - 7TH FL. |
| CITY |
STAMFORD |
| STATE |
Connecticut |
| ZIP/POSTAL CODE |
06901 |
| COUNTRY |
United States |
| PHONE |
800-575-2880 |
| FAX |
203-324-0555 |
| EMAIL |
XXXX |
| AUTHORIZED TO COMMUNICATE VIA E-MAIL |
Yes |
| LEGAL ENTITY SECTION (current) |
| TYPE |
individual |
| LEGAL ENTITY SECTION (proposed) |
| TYPE |
individual |
| COUNTRY OF CITIZENSHIP |
United States |
| PAYMENT SECTION |
| NUMBER OF CLASSES |
1 |
| NUMBER OF CLASSES PAID |
1 |
| SUBTOTAL AMOUNT |
100 |
| TOTAL FEE PAID |
100 |
| SIGNATURE SECTION |
| SIGNATURE |
/Dawn Pascale/ |
| SIGNATORY'S NAME |
Dawn Pascale |
| SIGNATORY'S POSITION |
Owner |
| DATE SIGNED |
03/09/2011 |
| PAYMENT METHOD |
CC |
| FILING INFORMATION |
| SUBMIT DATE |
Wed Mar 09 14:27:46 EST 2011 |
| TEAS STAMP |
USPTO/SECT08-XX.XX.XXX.XX
-20110309142746215297-296
9190-4802010d3e5a06d2ebca
7d9954f6ced399-CC-338-201
10309141604615756 |
| PTO Form 1553 (Rev 5/2006) |
| OMB No. 0651-0055 (Exp 12/31/2011) |
Declaration of Use and/or Excusable Nonuse of Mark in Commerce under Section 8
To the Commissioner for Trademarks:
REGISTRATION NUMBER: 2969190
REGISTRATION DATE: 07/19/2005
MARK: (Stylized and/or with Design, MEDSOURCE)
The owner, DAWN PASCALE, a citizen of United States, having an address of
300 MAIN ST. - 7TH FL.
STAMFORD, Connecticut 06901
United States
is filing a Declaration of Use and/or Excusable Nonuse of Mark in Commerce under Section 8.
For International Class 035, the mark is in use in commerce on or in connection with
all goods or services listed in the existing registration for this specific class: Consulting services to
the legal profession, namely, locating experts in the fields of medicine, nursing and allied health fields to review medical, render oral and/or written opinions and testimony ; or, the owner is
making the listed excusable nonuse claim.
The owner is submitting one specimen showing the mark as used in commerce on or in connection with any item in this class, consisting of a(n) scanned website page.
Original PDF file:
SPN0-759922926-141604615_._MEDSOURCE_10001.PDF
Converted PDF file(s) (1 page)
Specimen File1
The registrant's current Correspondence Information: WOODROW W. BAN of 1550 STONINGTON
HUDSON, Ohio (OH) 44236-1237
United States (USX)
The registrant's proposed Correspondence Information: PASCALE, DAWN
300 MAIN ST. - 7TH FL.
STAMFORD, Connecticut (CT) 06901
United States (USX)
The phone number is 800-575-2880.
The fax number is 203-324-0555.
The email address is dpascale@medsourceconsultants.com.
A fee payment in the amount of $100 will be submitted with the form, representing payment for 1 class(es), plus any additional grace period fee, if necessary.
Declaration
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.
Signature: /Dawn Pascale/ Date: 03/09/2011
Signatory's Name: Dawn Pascale
Signatory's Position: Owner
Serial Number: 76510098
Internet Transmission Date: Wed Mar 09 14:27:46 EST 2011
TEAS Stamp: USPTO/SECT08-XX.XX.XXX.XX-20110309142746
215297-2969190-4802010d3e5a06d2ebca7d995
4f6ced399-CC-338-20110309141604615756
