| 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 2300 (Rev 02/2020) |
| OMB No. 0651-0051 (Exp 11/30/2020) |
| Input Field | Entered |
|---|---|
| SERIAL NUMBER | 88066885 |
| REGISTRATION NUMBER | 5702673 |
| LAW OFFICE ASSIGNED | LAW OFFICE 100 |
| MARK SECTION | |
| MARK | SPRING HILL (standard characters, see http://tmng-al.uspto.gov /resting2/api/img/8806688 5/large) |
| OWNER SECTION(current) | |
| NAME | ASHBY BEHAVIORAL HEALTH, LLC |
| MAILING ADDRESS | 500 VICTORY ROAD, 3RD FLOOR |
| CITY | QUINCY |
| STATE | Massachusetts |
| STATE/COUNTRY/REGION/JURISDICTION/U.S. TERRITORY | United States |
| ZIP/POSTAL CODE | 02171 |
| ATTORNEY SECTION(current) | |
| NAME | Paul A. Borovay |
| ATTORNEY BAR MEMBERSHIP NUMBER | NOT SPECIFIED |
| YEAR OF ADMISSION | NOT SPECIFIED |
| U.S. STATE/ COMMONWEALTH/ TERRITORY | NOT SPECIFIED |
| FIRM NAME | POLSINELLI PC |
| STREET | 150 NORTH RIVERSIDE PLAZA, SUITE 3000 |
| CITY | CHICAGO |
| STATE | Illinois |
| STATE/COUNTRY/REGION/JURISDICTION/U.S. TERRITORY | United States |
| POSTAL/ZIP CODE | 60606 |
| PHONE | 312-873-3614 |
| pborovay@polsinelli.com | |
| CORRESPONDENCE SECTION(current) | |
| NAME | PAUL A. BOROVAY |
| PRIMARY EMAIL ADDRESS FOR CORRESPONDENCE | pborovay@polsinelli.com |
| SECONDARY EMAIL ADDRESS(ES) (COURTESY COPIES) | ahilton@polsinelli.com; lpellerito@polsinelli.com; uspt@polsinelli.com |
| OWNER SECTION(proposed) | |
| STATEMENT TEXT |
By submission of this request, the undersigned requests that the following be made of record for the owner/holder: |
| NAME | ASHBY BEHAVIORAL HEALTH, LLC |
| MAILING ADDRESS | 500 VICTORY ROAD, 3RD FLOOR |
| CITY | QUINCY |
| STATE | Massachusetts |
| STATE/COUNTRY/REGION/JURISDICTION/U.S. TERRITORY | United States |
| ZIP/POSTAL CODE | 02171 |
| XXXX | |
| STATEMENT OF THE REASON FOR REPLACEMENT | |
| The attorney of record is no longer with Polsinelli LLP | |
| ATTORNEY SECTION (proposed) | |
| STATEMENT TEXT | 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: |
| NAME | Nathaniel Weiner |
| ATTORNEY BAR MEMBERSHIP NUMBER | XXX |
| YEAR OF ADMISSION | XXXX |
| U.S. STATE/ COMMONWEALTH/ TERRITORY | XX |
| FIRM NAME | POLSINELLI LLP |
| STREET | Three Embarcadero Center, Suite 2400 |
| CITY | San Francisco |
| STATE | California |
| STATE/COUNTRY/REGION/JURISDICTION/U.S. TERRITORY | United States |
| POSTAL/ZIP CODE | 94111 |
| uspt@polsinelli.com | |
| CORRESPONDENCE SECTION (proposed) | |
| NAME | Nathaniel Weiner |
| PRIMARY EMAIL ADDRESS FOR CORRESPONDENCE | uspt@polsinelli.com |
| SECONDARY EMAIL ADDRESS(ES) (COURTESY COPIES) | nweiner@polsinelli.com; ahilton@polsinelli.com; MGutierrez@Polsinelli.com |
| SIGNATURE SECTION | |
| SIGNATURE | /Miya Yusa/ |
| SIGNATORY NAME | Miya Yusa |
| SIGNATORY DATE | 04/08/2020 |
| SIGNATORY POSITION | Associate Attorney, Polsinelli LLP, California bar member |
| AUTHORIZED SIGNATORY | YES |
| FILING INFORMATION SECTION | |
| SUBMIT DATE | Wed Apr 08 20:44:57 ET 2020 |
| TEAS STAMP | USPTO/CAR-XXX.XXX.XXX.X-2 0200408204457057679-88066 885-71081aaa72f586833351c 6128e4f706634b9d7673213f9 3e5159b691cb5dcc558e-N/A- N/A-20200408204121453279 |
| 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 2300 (Rev 02/2020) |
| OMB No. 0651-0051 (Exp 11/30/2020) |