TEAS Rev, App and/or COA of Atty/Dom.Rep

THEON

GENEIA LLC

Revocation, Appointment, and/or Change of Address of Attorney/Domestic Representative

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)

Revocation, Appointment, and/or Change of Address of Attorney/Domestic Representative

The table below presents the data as entered.

Input Field	Entered
SERIAL NUMBER	86296518
REGISTRATION NUMBER	4863996
LAW OFFICE ASSIGNED	LAW OFFICE 103
MARK SECTION
MARK	THEON (stylized and/or with design, see http://uspto.report/TM/86296518/mark.png)
ATTORNEY SECTION
ORIGINAL ADDRESS	John L. Ambrogi 80266/140234 321 N. Clark St., Suite 720 Chicago Illinois 60654-5011 US 312 634-9506 312 275-7503 tm@partridgeiplaw.com
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	Stephanie Michel-Segnor
FIRM NAME	Geneia LLC
STREET	1000 N Cameron Street, Suite 500
CITY	Harrisburg
STATE	Pennsylvania
COUNTRY	United States
POSTAL/ZIP CODE	17103
PHONE	717-775-3754
FAX	717-651-8078
EMAIL	mary.leberknight@capbluecross.com
ATTORNEY AUTHORIZED TO COMMUNICATE VIA E-MAIL	YES
NEW CORRESPONDENCE ADDRESS
NAME	Stephanie Michel-Segnor
FIRM NAME	Geneia LLC
STREET	1000 N Cameron Street, Suite 500
CITY	Harrisburg
STATE	Pennsylvania
COUNTRY	United States
POSTAL/ZIP CODE	17103
PHONE	717-775-3754
FAX	717-651-8078
EMAIL	mary.leberknight@capbluecross.com; stephanie.michel-segnor@geneia.com
AUTHORIZED TO COMMUNICATE VIA E-MAIL	YES
INDIVIDUAL ATTORNEY DOCKET/REFERENCE NUMBER
SIGNATURE SECTION
SIGNATURE	/Stephanie Michel-Segnor/
SIGNATORY NAME	Stephanie Michel-Segnor
SIGNATORY DATE	11/06/2018
SIGNATORY POSITION	VP Legal, Compliance and Legal Counsel
SIGNATORY PHONE NUMBER	717-775-3754
FILING INFORMATION SECTION
SUBMIT DATE	Tue Nov 06 10:31:03 EST 2018
TEAS STAMP	USPTO/RAA-X.XX.XXX.XXX-20 181106103103777102-862922 65-6106d8817ae7f7fbb4f9ae f22aec87c334e9032853e78d7 dce2a7e8c92fbe55ec-N/A-N/ A-20181106102549550486

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)

Revocation, Appointment, and/or Change of Address of Attorney/Domestic Representative

To the Commissioner for Trademarks:
MARK: THEON (stylized and/or with design, see http://uspto.report/TM/86296518/mark.png)
SERIAL NUMBER: 86296518
REGISTRATION NUMBER: 4863996

The original attorney information:
John L. Ambrogi
80266/140234
321 N. Clark St., Suite 720
Chicago Illinois 60654-5011
US
312 634-9506
312 275-7503
tm@partridgeiplaw.com

Original Correspondence Address :
John L. Ambrogi
Partridge & Garcia PC
321 N. Clark St., Suite 720
Chicago Illinois 60654-5011
US
312 634-9506
312 275-7503
tm@partridgeiplaw.com

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:

New attorney information:
Stephanie Michel-Segnor
Geneia LLC
1000 N Cameron Street, Suite 500
Harrisburg, Pennsylvania 17103
United States
717-775-3754
717-651-8078
mary.leberknight@capbluecross.com (authorized)

The following is to be used as the correspondence address:
Stephanie Michel-Segnor
Geneia LLC
1000 N Cameron Street, Suite 500
Harrisburg, Pennsylvania 17103
United States

717-775-3754
717-651-8078
mary.leberknight@capbluecross.com;stephanie.michel-segnor@geneia.com (authorized)

Signature: /Stephanie Michel-Segnor/ Date: 11/06/2018
Signatory's Name: Stephanie Michel-Segnor
Signatory's Position: VP Legal, Compliance and Legal Counsel
Signatory's Phone Number: 717-775-3754

Serial Number: 86296518
Internet Transmission Date: Tue Nov 06 10:31:03 EST 2018
TEAS Stamp: USPTO/RAA-X.XX.XXX.XXX-20181106103103777
102-86292265-6106d8817ae7f7fbb4f9aef22ae
c87c334e9032853e78d7dce2a7e8c92fbe55ec-N
/A-N/A-20181106102549550486

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