| PTO Form 1553 (Rev 9/2005) |
| OMB No. 0651-0054 (Exp. 11/30/2008) |
Trademark/Service Mark Statement of Use
(15 U.S.C. Section 1051(d))
The table below presents the data as entered.
| PTO Form 1553 (Rev 9/2005) |
| OMB No. 0651-0054 (Exp. 11/30/2008) |
Trademark/Service Mark Statement of Use
(15 U.S.C. Section 1051(d))
To the Commissioner for Trademarks:
MARK: LIFE SPINE
SERIAL NUMBER: 76567609
This Allegation of Use is being filed after a Notice of Allowance has issued.
The applicant, Life Spine, LLC, having an address of 10837 Pine Bluff, Fishers, Indiana United States 46038, is using or is using through a related company or licensee the mark in commerce on or in
connection with the goods and/or services as follows:
For International Class: 010, the applicant, or the applicant's related company or licensee, is using the mark in commerce on or in connection with all goods and/or services listed in the application
or Notice of Allowance.
The mark was first used by the applicant, or the applicant's related company, licensee, or predecessor in interest at least as early as 08/01/2004, and first used in commerce at least as early as
08/01/2004, and is now in use in such commerce. The applicant is submitting one specimen for the class showing the mark as used in commerce on or in connection with any item in the class, consisting
of a(n) Scanned image of a product, copy of company and product brochure, and digital photo of trade show booth with products and company logo at international meeting..
Specimen-1
Specimen-2
Specimen-3
For International Class: 016, the applicant, or the applicant's related company or licensee, is using the mark in commerce on or in connection with all goods and/or services listed in the application
or Notice of Allowance.
The mark was first used by the applicant, or the applicant's related company, licensee, or predecessor in interest at least as early as 08/01/2004, and first used in commerce at least as early as
08/01/2004, and is now in use in such commerce. The applicant is submitting one specimen for the class showing the mark as used in commerce on or in connection with any item in the class, consisting
of a(n) Scanned image of a product, copy of company and product brochure, and digital photo of trade show booth with products and company logo at international meeting..
Specimen-1
Specimen-2
Specimen-3
A fee payment in the amount of $200 will be submitted with the form, representing payment for 2 classes.
Declaration
Applicant requests registration of the above-identified trademark/service mark in the United States Patent and Trademark Office on the Principal Register established by the Act of July 5, 1946 (15
U.S.C. Section 1051 et seq., as amended). Applicant is the owner of the mark sought to be registered, and is using the mark in commerce on or in connection with the goods/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: /Michael S. Butler/ Date Signed: 06/08/2005
Signatory's Name: Michael S. Butler
Signatory's Position: President
RAM Sale Number: 1172
RAM Accounting Date: 06/08/2005
Serial Number: 76567609
Internet Transmission Date: Wed Jun 08 10:42:15 EDT 2005
TEAS Stamp: USPTO/SOU-XX.XX.XX.XX-200506081042157889
98-76567609-250f9bbc0b2ae9e73b5e7c47e674
fddcf83-CC-1172-20050608101822993271
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