| 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 |
2930393 |
| REGISTRATION DATE |
03/08/2005 |
| SERIAL NUMBER |
76578884 |
| MARK SECTION |
| MARK |
RELION (stylized and/or with design) |
| CORRESPONDENCE SECTION (current) |
| NAME |
Myron Eng |
| STREET |
702 SW 8th Street |
| CITY |
BENTONVILLE |
| STATE |
Arkansas |
| POSTAL CODE |
72716-0520 |
| COUNTRY |
United States |
| PHONE |
479-273-4505 |
| FAX |
479-277-5889 |
| EMAIL |
ustm@walmartlegal.com |
| AUTHORIZED TO COMMUNICATE VIA E-MAIL |
Yes |
| DOCKET/REFERENCE NUMBER |
0659-US-NF-6 |
| CORRESPONDENCE SECTION (proposed) |
| NAME |
Sandra Buja |
| FIRM NAME |
Wal-Mart Stores, Inc. |
| STREET |
702 SW 8th Street |
| CITY |
BENTONVILLE |
| STATE |
Arkansas |
| POSTAL CODE |
72716 |
| COUNTRY |
United States |
| EMAIL |
ustm@walmartlegal.com |
| AUTHORIZED TO COMMUNICATE VIA E-MAIL |
Yes |
| DOCKET/REFERENCE NUMBER |
81046462 |
| GOODS AND/OR SERVICES SECTION |
| INTERNATIONAL CLASS |
010 |
| GOODS OR SERVICES |
Pen needles |
| SPECIMEN FILE NAME(S) |
\\TICRS\EXPORT16\IMAGEOUT 16\765\788\76578884\xml2\ S890002.JPG |
| SPECIMEN DESCRIPTION |
a photo of the use of the trademark on the goods. |
| OWNER SECTION (current) |
| NAME |
WAL-MART STORES, INC. |
| STREET |
702 SW 8th Street |
| CITY |
Bentonville |
| STATE |
Arkansas |
| ZIP/POSTAL CODE |
72716-8095 |
| COUNTRY |
United States |
| OWNER SECTION (proposed) |
| NAME |
WAL-MART STORES, INC. |
| STREET |
702 SW 8th Street |
| CITY |
Bentonville |
| STATE |
Arkansas |
| ZIP/POSTAL CODE |
72716 |
| COUNTRY |
United States |
| EMAIL |
XXXX |
| AUTHORIZED TO COMMUNICATE VIA E-MAIL |
Yes |
| LEGAL ENTITY SECTION (current) |
| TYPE |
corporation |
| STATE/COUNTRY OF INCORPORATION |
Delaware |
| PAYMENT SECTION |
| NUMBER OF CLASSES |
1 |
| NUMBER OF CLASSES PAID |
1 |
| SUBTOTAL AMOUNT |
400 |
| TOTAL FEE PAID |
400 |
| SIGNATURE SECTION |
| SIGNATURE |
/sandra buja/ |
| SIGNATORY'S NAME |
Sandra Buja |
| SIGNATORY'S POSITION |
Associate General Counsel |
| DATE SIGNED |
02/12/2015 |
| PAYMENT METHOD |
DA |
| FILING INFORMATION |
| SUBMIT DATE |
Thu Feb 12 17:47:36 EST 2015 |
| TEAS STAMP |
USPTO/S08N09-XXX.XXX.XXX.
XXX-20150212174736676137-
2930393-5304134d8744084c4
8036a59ef83afa3e1173897b6
74607594fba0a686224232d-D
A-4600-201502121746090226
58 |
| 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: 2930393
REGISTRATION DATE: 03/08/2005
MARK: (Stylized and/or with Design, RELION)
The owner, WAL-MART STORES, INC., a corporation of Delaware, having an address of
702 SW 8th Street
Bentonville, Arkansas 72716
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 010, 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: Pen needles ; 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) a photo of the use of the trademark on the
goods..
Specimen File1
The registrant's current Correspondence Information: Myron Eng
702 SW 8th Street
BENTONVILLE, Arkansas (AR) 72716-0520
United States
The docket/reference number is 0659-US-NF-6.
The registrant's proposed Correspondence Information: Sandra Buja of Wal-Mart Stores, Inc.
702 SW 8th Street
BENTONVILLE, Arkansas (AR) 72716
United States
The docket/reference number is 81046462.
The email address is ustm@walmartlegal.com.
A fee payment in the amount of $400 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/services identified above, as evidenced by the attached specimen(s)
showing the mark as used in commerce.
The signatory being 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 submission, declares that all statements made of his/her own knowledge are true and 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: /sandra buja/ Date: 02/12/2015
Signatory's Name: Sandra Buja
Signatory's Position: Associate General Counsel
Serial Number: 76578884
Internet Transmission Date: Thu Feb 12 17:47:36 EST 2015
TEAS Stamp: USPTO/S08N09-XXX.XXX.XXX.XXX-20150212174
736676137-2930393-5304134d8744084c48036a
59ef83afa3e1173897b674607594fba0a6862242
32d-DA-4600-20150212174609022658
