Change Address or Representation Form

EVERCOMMERCE

EVERCOMMERCE SOLUTIONS INC.

Change Address or Representation Form

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)

Change Address or Representation Form


The table below presents the data as entered.

Input Field Entered
SERIAL NUMBER 88123327
REGISTRATION NUMBER 5733708
LAW OFFICE ASSIGNED LAW OFFICE 116
MARK SECTION
MARK EVERCOMMERCE (stylized and/or with design, see http://tmng-al.uspto.gov /resting2/api/img/8812332 7/large)
OWNER SECTION(current)
NAME PaySimple, Inc.
MAILING ADDRESS 1515 Wynkoop St., Ste. 250
CITY Denver
STATE Colorado
STATE/COUNTRY/REGION/JURISDICTION/U.S. TERRITORY United States
ZIP/POSTAL CODE 80202
PHONE 303-800-0579
EMAIL XXXX
CORRESPONDENCE SECTION(current)
NAME LISA HEPHNER
PRIMARY EMAIL ADDRESS FOR CORRESPONDENCE lisa@paysimple.com
SECONDARY EMAIL ADDRESS(ES) (COURTESY COPIES) NOT PROVIDED
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 PaySimple, Inc.
MAILING ADDRESS 3601 Walnut Street, Suite 400
CITY Denver
STATE Colorado
STATE/COUNTRY/REGION/JURISDICTION/U.S. TERRITORY United States
ZIP/POSTAL CODE 80205
PHONE 800-466-0992
EMAIL XXXX
CORRESPONDENCE SECTION (proposed)
NAME PAYSIMPLE, INC.
PRIMARY EMAIL ADDRESS FOR CORRESPONDENCE lisa@paysimple.com
SECONDARY EMAIL ADDRESS(ES) (COURTESY COPIES) NOT PROVIDED
SIGNATURE SECTION
SIGNATURE /LisaHephner-ps41020/
SIGNATORY NAME Hephner, Lisa
SIGNATORY DATE 04/10/2020
SIGNATORY POSITION Vice President
SIGNATORY PHONE NUMBER 3038000579
AUTHORIZED SIGNATORY YES
FILING INFORMATION SECTION
SUBMIT DATE Fri Apr 10 15:26:12 ET 2020
TEAS STAMP USPTO/CAR-XX.XXX.XXX.XXX-
20200410152612283968-7773
9518-710d14eaacdf091fbdca
12112d8c215dbb55390c336b7
2854268e5ca2837e0ec3c-N/A
-N/A-20200410151159091297



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)


Change Address or Representation Form


To the Commissioner for Trademarks:

MARK: EVERCOMMERCE (stylized and/or with design, see http://tmng-al.uspto.gov /resting2/api/img/8812332 7/large)
SERIAL NUMBER: 88123327
REGISTRATION NUMBER: 5733708


Owner Section (Current) :
PaySimple, Inc.
1515 Wynkoop St., Ste. 250
Denver, Colorado 80202
United States
303-800-0579
XXXX
Correspondence Section (Current):
LISA HEPHNER
PRIMARY EMAIL ADDRESS FOR CORRESPONDENCE: lisa@paysimple.com
SECONDARY EMAIL ADDRESS(ES) (COURTESY COPIES): NOT PROVIDED


By submission of this request, the undersigned requests that the following be made of record for the owner/holder:

Owner Section (proposed):
PaySimple, Inc.
3601 Walnut Street, Suite 400
Denver, Colorado 80205
United States
800-466-0992
XXXXCorrespondence Section (proposed):
PAYSIMPLE, INC.
PRIMARY EMAIL ADDRESS FOR CORRESPONDENCE: lisa@paysimple.com
SECONDARY EMAIL ADDRESS(ES) (COURTESY COPIES): NOT PROVIDED




Signature: /LisaHephner-ps41020/      Date: 04/10/2020
Signatory's Name: Hephner, Lisa
Signatory's Position: Vice President
Signatory's Phone Number: 3038000579

Serial Number: 88123327
Internet Transmission Date: Fri Apr 10 15:26:12 ET 2020
TEAS Stamp: USPTO/CAR-XX.XXX.XXX.XXX-202004101526122
83968-77739518-710d14eaacdf091fbdca12112
d8c215dbb55390c336b72854268e5ca2837e0ec3
c-N/A-N/A-20200410151159091297



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