| PTO Form 2196 (Rev 9/2005) |
| OMB No. 0651-0056 (Exp 09/30/2011) |
| Input Field | Entered |
|---|---|
| SERIAL NUMBER | 78527645 |
| LAW OFFICE ASSIGNED | LAW OFFICE 114 |
| MARK SECTION | |
| MARK | AEROPALM |
| DOMESTIC REPRESENTATIVE SECTION | |
| ORIGINAL ADDRESS | Sheldon R. Pontaoe 919/483-7988 919/483-2519 |
| CORRESPONDENCE SECTION | |
| ORIGINAL ADDRESS | Maribeth D. Case GLAXOSMITHKLINE FIVE MOORE DRIVE MAI-B443 RESEARCH TRIANGLE PARK NC 27709 919/483-7988 919/483-2519 trademarks@gsk.com |
| NEW DOMESTIC REPRESENTATIVE ADDRESS | |
| STATEMENT TEXT | By submission of this request, the undersigned REVOKES the power of domestic representative currently of record, as listed above, and hereby APPOINTS the following new domestic representative: |
| NAME | Maribeth Day Case |
| FIRM NAME | GlaxoSmithKline |
| INTERNAL ADDRESS | CIP TRADEMARKS - MAI.B475-D |
| STREET | 5 Moore Drive |
| CITY | Research Triangle Park |
| STATE | North Carolina |
| COUNTRY | United States |
| POSTAL/ZIP CODE | 27709 |
| PHONE | 919 483 1803 |
| FAX | 704 625 9190 |
| RTP_TM-Trademarks@gsk.com | |
| REPRESENTATIVE AUTHORIZED TO COMMUNICATE VIA E-MAIL | YES |
| NEW CORRESPONDENCE ADDRESS | |
| NAME | Maribeth Day Case |
| FIRM NAME | GlaxoSmithKline |
| INTERNAL ADDRESS | CIP TRADEMARKS - MAI.B475-D |
| STREET | 5 Moore Drive |
| CITY | Research Triangle Park |
| STATE | North Carolina |
| COUNTRY | United States |
| POSTAL/ZIP CODE | 27709 |
| PHONE | 919 483 1803 |
| FAX | 704 625 9190 |
| RTP_TM-Trademarks@gsk.com | |
| AUTHORIZED TO COMMUNICATE VIA E-MAIL | YES |
| SIGNATURE SECTION | |
| SIGNATURE | /pam/ |
| SIGNATORY NAME | Pamela A May |
| SIGNATORY DATE | 04/15/2008 |
| SIGNATORY POSITION | Attorney of Record |
| FILING INFORMATION SECTION | |
| SUBMIT DATE | Tue Apr 15 10:05:49 EDT 2008 |
| TEAS STAMP | USPTO/RAA-XXX.XX.XXX.XXX- 20080415100549325664-7852 7645-400d44ea123c89fa4f8e 6442a33d8b144-N/A-N/A-200 80414164534762832 |
| PTO Form 2196 (Rev 9/2005) |
| OMB No. 0651-0056 (Exp 09/30/2011) |