Teas Change of Owner Address

POLYNESIAN

McCarthy, Kathy J.

Change Of Owner's Address

PTO Form 2197 (Rev 09/2005)

OMB No. 0651-0056 (Exp 09/30/2011)

Change Of Owner's Address

The table below presents the data as entered.

Input Field	Entered
SERIAL NUMBER	77002713
REGISTRATION NUMBER	3321927
LAW OFFICE ASSIGNED	LAW OFFICE 111
MARK SECTION
MARK	POLYNESIAN
OWNER SECTION (current)
NAME	McCarthy, Kathy J.
STREET	2109 Spyglass Trail West
CITY	Oxnard
STATE	California
ZIP/POSTAL CODE	93036-2791
COUNTRY	United States
PHONE	805.201.0628
FAX	805.201.7004
CORRESPONDENCE SECTION (current)
ORIGINAL ADDRESS	MCCARTHY, KATHY J. 2109 Spyglass Trail West Oxnard California 93036-2791 United States 805.201.7004 805.201.0628 kmccarthy55@yahoo.com
NEW OWNER ADDRESS
STREET	2233 Bermuda Dunes Place
CITY	Oxnard
STATE	California
ZIP/POSTAL CODE	93036-2782
COUNTRY	United States
PHONE	805.201.0628
FAX	805.201.0440
CURRENT CORRESPONDENCE ADDRESS
NAME	MCCARTHY, KATHY J.
STREET	2233 Bermuda Dunes Place
CITY	Oxnard
STATE	California
COUNTRY	United States
POSTAL/ZIP CODE	93036-2782
PHONE	805.201.0628
FAX	805.201.0440
SIGNATURE SECTION
SIGNATURE	/Kathy J. McCarthy/
SIGNATORY NAME	/Kathy J. McCarthy/
SIGNATORY DATE	01/23/2009
SIGNATORY POSITION	Owner
FILING INFORMATION SECTION
SUBMIT DATE	Fri Jan 23 20:04:22 EST 2009
TEAS STAMP	USPTO/COA-XX.XXX.XX.XX-20 090123200422786251-770027 13-400dbd744b6f6f77c85d0d d4f8dd8a5c5f4-N/A-N/A-200 90123195323128595

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