Change Address or Representation Form

PTO- 2300

Approved for use through 07/31/2024. OMB 0651-0056

U.S. Patent and Trademark Office; U.S. DEPARTMENT OF COMMERCE Under the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it contains a valid OMB control number

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PTO- 2300

Approved for use through 07/31/2024. OMB 0651-0056

U.S. Patent and Trademark Office; U.S. DEPARTMENT OF COMMERCE Under the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it contains a valid OMB control number

Change Address or Representation Form

To the Commissioner for Trademarks:

MARK: HOSPITAL CHOICE SAVINGS (standard characters, see http://uspto.report/TM/87114471/mark.png)
SERIAL NUMBER: 87114471
REGISTRATION NUMBER: 5175364

Attorney Section (Current):
Martha Zajicek of MUTUAL OF OMAHA INSURANCE COMPANY
XX bar, admitted in XXXX, bar membership no. XXX, is located at
LAW OPERATION - FLOOR 3
MUTUAL OF OMAHA PLAZA
OMAHA, Nebraska 68175-1008
United States
402-351-2421
402-351-2000
Email Address: martha.zajicek@mutualofomaha.com

STATEMENT OF THE REASON FOR REPLACEMENT
The Trademark Owner is replacing its Attorney of Record, Martha Zajicek, with its new Attorney of Record, Timothy Waggoner.

By submission of this request, the undersigned confirms that (1) representation is ongoing and (2) that the individual listed below should now be identified as the attorney of record:

Attorney Section (proposed):
Timothy Waggoner of MUTUAL OF OMAHA INSURANCE COMPANY
XX bar, admitted in XXXX, bar membership no. XXX, is located at
LAW OPERATION - FLOOR 3
3300 MUTUAL OF OMAHA PLAZA
OMAHA, Nebraska 68175-1008
United States
402-351-6605
402-351-2000
tim.waggoner@mutualofomaha.com
Timothy Waggoner submitted the following statement: The attorney of record is an active member in good standing of the bar of the highest court of a U.S. state, the District of Columbia, or any U.S. Commonwealth or territory.
Correspondence Section (Current):
Martha Zajicek
PRIMARY EMAIL ADDRESS FOR CORRESPONDENCE: martha.zajicek@mutualofomaha.com
SECONDARY EMAIL ADDRESS(ES) (COURTESY COPIES): NOT PROVIDED

Correspondence Section (proposed):
Timothy Waggoner
PRIMARY EMAIL ADDRESS FOR CORRESPONDENCE: tim.waggoner@mutualofomaha.com
SECONDARY EMAIL ADDRESS(ES) (COURTESY COPIES): NOT PROVIDED


Requirement for Email and Electronic Filing: I understand that a valid email address must be maintained by the owner/holder and the owner's/holder's attorney, if appointed, and that all official trademark correspondence must be submitted via the Trademark Electronic Application System (TEAS).


Signature: /Martha Zajicek/      Date: 10/27/2023
Signatory's Name: Martha Zajicek
Signatory's Position: Sr Associate General Counsel
Signatory's Phone Number: 402-351-2421
Signature method: Sent to third party for signature

The signatory has confirmed that he/she is a U.S.-licensed attorney who is an active member in good standing of the bar of the highest court of a U.S. state (including the District of Columbia and any U.S. Commonwealth or territory); and he/she is currently the owner's/holder's attorney or an associate thereof; and to the best of his/her knowledge, if prior to his/her appointment another U.S.-licensed attorney not currently associated with his/her company/firm previously represented the owner/holder in this matter: the owner/holder has revoked their power of attorney by a signed revocation or substitute power of attorney with the USPTO; the USPTO has granted that attorney's withdrawal request; the owner/holder has filed a power of attorney appointing him/her in this matter; or the owner's/holder's appointed U.S.-licensed attorney has filed a power of attorney appointing him/her as an associate attorney in this matter.


Serial Number: 87114471
Internet Transmission Date: Mon Oct 30 09:37:51 ET 2023
TEAS Stamp: USPTO/CAR-XXX.XX.XX.XXX-2023103009375104
7572-97037522-85046fc2283724949ade086e3c
8b25c3ff12fbd848f94c89216b2941e4dec3-N/A
-N/A-20231027101605801622