| Under the Paperwork Reduction Act of 1995 no persons are required to respond to a collection of information unless it displays a valid OMB control number. PTO Form 2196 (Rev 09/2005) |
| OMB No. 0651-0056 (Exp 11/30/2020) |
| Input Field | Entered |
|---|---|
| SERIAL NUMBER | 85822820 |
| REGISTRATION NUMBER | 4813243 |
| LAW OFFICE ASSIGNED | LAW OFFICE 114 |
| ATTORNEY DOCKET NUMBER | GFO-608 |
| MARK SECTION | |
| MARK | PERIMETER (see, http://uspto.report/TM/85822820/mark.png) |
| CURRENT ATTORNEY ADDRESS | |
| NAME | Michele J. Young |
| ATTORNEY BAR MEMBERSHIP NUMBER | NOT SPECIFIED |
| YEAR OF ADMISSION | NOT SPECIFIED |
| U.S. STATE/ COMMONWEALTH/ TERRITORY | NOT SPECIFIED |
| FIRM NAME | G-FORM, LLC |
| STREET | 233 Richmond Street |
| CITY | PROVIDENCE |
| STATE | Rhode Island |
| COUNTRY | US |
| POSTAL/ZIP CODE | 02903-4755 |
| PHONE | 401.250.5555 |
| FAX | 401.415.0145 |
| ip@g-form.com | |
| ATTORNEY AUTHORIZED TO COMMUNICATE VIA E-MAIL | YES |
| CURRENT CORRESPONDENCE ADDRESS | |
| NAME | MICHELE J. YOUNG |
| FIRM NAME | G-FORM, LLC |
| STREET | 233 Richmond Street |
| CITY | PROVIDENCE |
| STATE | Rhode Island |
| COUNTRY | US |
| POSTAL/ZIP CODE | 02903-4755 |
| PHONE | 401.250.5555 |
| FAX | 401.273.0258 |
| ip@g-form.com | |
| AUTHORIZED TO COMMUNICATE VIA E-MAIL | YES |
| NEW ATTORNEY INFORMATION | |
| STATEMENT TEXT | By submission of this request, the undersigned REVOKES the power of attorney currently of record, as listed above, and hereby APPOINTS the following new attorney. |
| NAME | Deborah J Peckham |
| ATTORNEY BAR MEMBERSHIP NUMBER | XXX |
| YEAR OF ADMISSION | XXXX |
| U.S. STATE/ COMMONWEALTH/ TERRITORY | XX |
| FIRM NAME | Burns & Levinson LLP |
| STREET | 125 High Street |
| CITY | Boston |
| STATE | Massachusetts |
| COUNTRY | United States |
| POSTAL/ZIP CODE | 02110 |
| PHONE | 617.345.3000 |
| FAX | 617.345.3299 |
| trademarks@burnslev.com | |
| ATTORNEY AUTHORIZED TO COMMUNICATE VIA E-MAIL | YES |
| INDIVIDUAL ATTORNEY DOCKET/REFERENCE NUMBER |
GFO-608 |
| OTHER APPOINTED ATTORNEY | Brooke Penrose, Eilene Duberow, Bruce Jobse, Jerry Cohen |
| NEW CORRESPONDENCE INFORMATION | |
| NAME | Deborah J Peckham |
| FIRM NAME | Burns & Levinson LLP |
| STREET | 125 High Street |
| CITY | Boston |
| STATE | Massachusetts |
| COUNTRY | United States |
| POSTAL/ZIP CODE | 02110 |
| PHONE | 617.345.3000 |
| FAX | 617.345.3299 |
| trademarks@burnslev.com | |
| AUTHORIZED TO COMMUNICATE VIA E-MAIL | YES |
| INDIVIDUAL ATTORNEY DOCKET/REFERENCE NUMBER |
GFO-608 |
| SIGNATURE SECTION | |
| SIGNATURE | /Glen Giovanucci/ |
| SIGNATORY NAME | Glen Giovanucci |
| SIGNATORY DATE | 11/06/2019 |
| SIGNATORY POSITION | CEO |
| FILING INFORMATION SECTION | |
| SUBMIT DATE | Wed Nov 06 15:49:14 EST 2019 |
| TEAS STAMP | USPTO/RAA-XX.XXX.XXX.XXX- 20191106154914867229-8582 2820-700efe4aad9bcc0b11f8 cfdfd4fa2d47ce86983a7d0d9 8b844fb1ba2d710ca86-N/A-N /A-20191106150830764651 |
| Under the Paperwork Reduction Act of 1995 no persons are required to respond to a collection of information unless it displays a valid OMB control number. PTO Form 2196 (Rev 09/2005) |
| OMB No. 0651-0056 (Exp 11/30/2020) |