| PTO Form 1966 (Rev 9/2002) |
| OMB Control #0651-0050 (Exp. 04/30/2006) |
| Input Field |
Entered |
| SERIAL NUMBER | 76520559 |
| MARK SECTION (no change) | |
| ADDITIONAL STATEMENTS SECTION | |
| MISCELLANEOUS STATEMENT | Please amend this application to the Supplemental Register. |
| CORRESPONDENCE SECTION | |
| NAME | Gary Ferguson Jobe |
| STREET | 1300 NW 53rd Drive |
| CITY | Portland |
| STATE | OR |
| ZIP/POSTAL CODE | 97210 |
| COUNTRY | USA |
| PHONE | 503.243.1132 |
| mindbodywork@earthlink.net | |
| AUTHORIZED TO COMMUNICATE VIA E-MAIL | Yes |
| SIGNATURE SECTION | |
| SIGNATURE | /gj/ |
| SIGNATORY NAME | Gary Ferguson Jobe |
| SIGNATORY POSITION | Applicant |
| SIGNATORY DATE | 05/21/2004 |
| SIGNATURE | /gj/ |
| SIGNATORY NAME | Gary Ferguson Jobe |
| SIGNATORY POSITION | Applicant |
| SIGNATORY DATE | 05/21/2004 |
| FILING INFORMATION SECTION | |
| SUBMIT DATE | Fri May 21 18:51:17 EDT 2004 |
| TEAS STAMP | USPTO/OA-XXXXXXXXXXX-2004 0521185117305156-76520559 -200feae9f41ad71f5a54bf21 5a34e30b4a-N-N-2004052118 4914040865 |
| PTO Form 1966 (Rev 9/2002) |
| OMB Control #0651-0050 (Exp. 04/30/2006) |
| Application serial no. 76520559 is amended as follows: | |
| Correspondence Address Change | |
| Applicant proposes to amend the following: | |
| Original: GARY FERGUSON JOBE 2021 NW 29TH STREET #2 PORTLAND, OR 97210 | |
| Proposed: Gary Ferguson Jobe, having an address of 1300 NW 53rd Drive Portland, OR USA 97210, whose e-mail address is mindbodywork@earthlink.net, whose phone number is 503.243.1132. | |
| Additional Statements | |
| Please amend this application to the Supplemental Register. | |
| 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. Section 1001, and that such willful false statements may jeopardize the validity of the application or any resulting registration, declares that he/she is properly authorized to execute this amendment/response on behalf of the applicant; he/she believes the applicant to be the owner of the trademark/service mark sought to be registered, and that the mark is in use in commerce, and was in use in commerce on the application filing date, on or in connection with the goods and/or services listed in the application; or, if the application is being filed under 15 U.S.C. Section 1051(b), 1126(d) or 1126(e), he/she believes applicant to be entitled to use such mark in commerce, and that the applicant has a bona fide intention, and had a bona fide intention on the application filing date, to use the mark in commerce on or in connection with the goods and/or services listed in the application; to the best of his/her knowledge and belief no other person, firm, corporation, or association has the right to use the mark in commerce, either in the identical form thereof or in such near resemblance thereto as to be likely, when used on or in connection with the goods and/or services of such other person, to cause confusion, or to cause mistake, or to deceive; and that all statements made of his/her own knowledge are true; and that all statements made on information and belief are believed to be true as set forth within the original application and/or the submitted amendment/response. | |
| Signature: /gj/ Date: 05/21/2004 | |
| Signatory's Name: Gary Ferguson Jobe | |
| Signatory's Position: Applicant | |
| Response Signature | |
| Signature: /gj/ Date: 05/21/2004 | |
| Signatory's Name: Gary Ferguson Jobe | |
| Signatory's Position: Applicant | |
| Mailing Address: | |
| Gary Ferguson Jobe | |
| 1300 NW 53rd Drive | |
| Portland, OR 97210 | |
| Serial Number: 76520559 | |
| Internet Transmission Date: Fri May 21 18:51:17 EDT 2004 | |
| TEAS Stamp: USPTO/OA-XXXXXXXXXXX-2004052118511730515 6-76520559-200feae9f41ad71f5a54bf215a34e 30b4a-N-N-20040521184914040865 |