Trademark/Service Mark Application, Principal Register
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 1478 (Rev 09/2006)
OMB No. 0651-0009 (Exp 02/28/2021)
Trademark/Service Mark Application, Principal Register
TEAS Plus Application
Serial Number:88002018
Filing Date:06/15/2018
NOTE: Data fields with the * are mandatory under TEAS Plus. The wording "(if applicable)" appears where the field is only mandatory under the facts of the particular
application.
*DESCRIPTION OF THE MARK
(and Color Location, if applicable)
The mark consists of of two vertical wavy lines in front of the words LASER SPINE INSTITUTE, wherein the term INSTITUTE appears below the terms
LASER SPINE.
PIXEL COUNT ACCEPTABLE
YES
PIXEL COUNT
903 x 296
REGISTER
Principal
APPLICANT INFORMATION
*OWNER OF MARK
Laser Spine Institute, LLC
DBA/AKA/TA/FORMERLY
AKA Laser Spine Institute or LSI
*STREET
5332 Avion Park Dr.
*CITY
Tampa
*STATE
(Required for U.S. applicants)
Florida
*COUNTRY
United States
*ZIP/POSTAL CODE
(Required for U.S. and certain international addresses)
Website displaying mark and showing services offered.
ADDITIONAL STATEMENTS SECTION
*TRANSLATION
(if applicable)
*TRANSLITERATION
(if applicable)
*CLAIMED PRIOR REGISTRATION
(if applicable)
The applicant claims ownership of active prior U.S. Registration Number(s) 4703864, 4316307, and 3478447.
*CONSENT (NAME/LIKENESS)
(if applicable)
*CONCURRENT USE CLAIM
(if applicable)
ATTORNEY INFORMATION
NAME
Scott D. Locke
ATTORNEY DOCKET NUMBER
LaserSp 36US
FIRM NAME
Dorf & Nelson LLP
STREET
555 Theodore Fremd Ave
CITY
Rye
STATE
New York
COUNTRY
United States
ZIP/POSTAL CODE
10580
PHONE
914-381-7600
FAX
914-381-7608
EMAIL ADDRESS
slocke@dorflaw.com
AUTHORIZED TO COMMUNICATE VIA EMAIL
Yes
CORRESPONDENCE INFORMATION
*NAME
Scott D. Locke
FIRM NAME
Dorf & Nelson LLP
*STREET
555 Theodore Fremd Ave
*CITY
Rye
*STATE
(Required for U.S. addresses)
New York
*COUNTRY
United States
*ZIP/POSTAL CODE
10580
PHONE
914-381-7600
FAX
914-381-7608
*EMAIL ADDRESS
slocke@dorflaw.com; tlebrun@dorflaw.com
*AUTHORIZED TO COMMUNICATE VIA EMAIL
Yes
FEE INFORMATION
APPLICATION FILING OPTION
TEAS Plus
NUMBER OF CLASSES
1
FEE PER CLASS
225
*TOTAL FEE PAID
225
SIGNATURE INFORMATION
* SIGNATURE
/Scott D. Locke/
* SIGNATORY'S NAME
Scott D. Locke
* SIGNATORY'S POSITION
Attorney of record, New York bar member
SIGNATORY'S PHONE NUMBER
914-381-7600
* DATE SIGNED
06/15/2018
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 1478 (Rev 09/2006)
OMB No. 0651-0009 (Exp 02/28/2021)
Trademark/Service Mark Application, Principal Register
TEAS Plus Application
Serial Number:88002018
Filing Date:06/15/2018
To the Commissioner for Trademarks:
MARK: Laser Spine Institute (stylized and/or with design, see mark)
The mark in your application is Laser Spine Institute.
The mark consists of of two vertical wavy lines in front of the words LASER SPINE INSTITUTE, wherein the term INSTITUTE appears below the terms LASER SPINE.
The applicant, Laser Spine Institute, LLC, AKA Laser Spine Institute or LSI, a limited liability company legally organized under the laws of Florida, having an address of
5332 Avion Park Dr.
Tampa, Florida 33607
United States
requests registration of the trademark/service mark identified above in the United States Patent and Trademark Office on the Principal Register established by the Act of July 5, 1946 (15 U.S.C.
Section 1051 et seq.), as amended, for the following:
For specific filing basis information for each item, you must view the display within the Input Table.
International Class 044: Medical services; Minimally invasive surgical services; Surgical services, namely, spinal therapies
Use in Commerce: The applicant is using the mark in commerce on or in connection with the identified goods/services. The applicant attaches, or will later submit, one specimen as a JPG/PDF image file
showing the mark as used in commerce on or in connection with any item in the class of listed goods/services, regardless of whether the mark itself is in the standard character format or is a
stylized or design mark. The specimen image file may be in color, and the image must be in color if color is being claimed as a feature of the mark.
In International Class 044, the mark was first used by the applicant or the applicant's related company or licensee predecessor in interest at least as early as 09/28/2015, and first used in commerce
at least as early as 09/28/2015, and is now in use in such commerce. The applicant is submitting one(or more) specimen(s) showing the mark as used in commerce on or in connection with any item in the
class of listed goods/services, consisting of a(n) Website displaying mark and showing services offered..
Claim of Active Prior Registration(s)
The applicant claims ownership of active prior U.S. Registration Number(s) 4703864, 4316307, and 3478447.
The applicant's current Attorney Information:
Scott D. Locke of Dorf & Nelson LLP 555 Theodore Fremd Ave
Rye, New York 10580
United States
914-381-7600(phone)
914-381-7608(fax)
slocke@dorflaw.com (authorized)
The attorney docket/reference number is LaserSp 36US.
The applicant's current Correspondence Information:
Scott D. Locke
Dorf & Nelson LLP
555 Theodore Fremd Ave
Rye, New York 10580
914-381-7600(phone)
914-381-7608(fax)
slocke@dorflaw.com;tlebrun@dorflaw.com (authorized) E-mail Authorization: I authorize the USPTO to send e-mail correspondence concerning the application to the applicant or the applicant's attorney, or the applicant's domestic representative at
the e-mail address provided in this application. I understand that a valid e-mail address must be maintained and that the applicant or the applicant's attorney must file the relevant subsequent
application-related submissions via the Trademark Electronic Application System (TEAS). Failure to do so will result in the loss of TEAS Plus status and a requirement to submit an additional
processing fee of $125 per international class of goods/services.
A fee payment in the amount of $225 has been submitted with the application, representing payment for 1 class(es).
Declaration
Declaration Signature
Signature: /Scott D. Locke/ Date: 06/15/2018
Signatory's Name: Scott D. Locke
Signatory's Position: Attorney of record, New York bar member
Signatory's Phone Number: 914-381-7600
Payment Sale Number: 88002018
Payment Accounting Date: 06/15/2018
Serial Number: 88002018
Internet Transmission Date: Fri Jun 15 11:20:03 EDT 2018
TEAS Stamp: USPTO/FTK-XXX.XXX.XXX.XXX-20180615112003
384721-88002018-6103e76f75534f8bf234671f
c234bc90dcbf3d078b557ed798c913e7adb28a7a
-CC-8884-20180615111705905304