| 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 | 88342355 |
| LAW OFFICE ASSIGNED | LAW OFFICE 121 |
| MARK SECTION | |
| MARK | THAT'S THE BENEFIT OF BLUE (standard characters, see http://tmng-al.uspto.gov /resting2/api/img/8834235 5/large) |
| OWNER SECTION(current) | |
| NAME | Blue Cross and Blue Shield Association |
| MAILING ADDRESS | 225 N. Michigan Ave. |
| CITY | Chicago |
| STATE | Illinois |
| STATE/COUNTRY/REGION/JURISDICTION/U.S. TERRITORY | United States |
| ZIP/POSTAL CODE | 60601 |
| ATTORNEY SECTION(current) | |
| NAME | J. Ryan Hinshaw |
| ATTORNEY BAR MEMBERSHIP NUMBER | XXX |
| YEAR OF ADMISSION | XXXX |
| U.S. STATE/ COMMONWEALTH/ TERRITORY | XX |
| FIRM NAME | Blue Cross and Blue Shield Association |
| STREET | 225 North Michigan Avenue |
| CITY | Chicago |
| STATE | Illinois |
| STATE/COUNTRY/REGION/JURISDICTION/U.S. TERRITORY | United States |
| POSTAL/ZIP CODE | 60601 |
| trademarks@bcbsa.com | |
| DOCKET/REFERENCE NUMBER(S) | 10503EF |
| CORRESPONDENCE SECTION(current) | |
| NAME | J. Ryan Hinshaw |
| PRIMARY EMAIL ADDRESS FOR CORRESPONDENCE | trademarks@bcbsa.com |
| SECONDARY EMAIL ADDRESS(ES) (COURTESY COPIES) | ryan.hinshaw@bcbsa.com; cynthia.stevens@bcbsa.com |
| DOCKET/REFERENCE NUMBER(S) | 10503EF |
| 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 | Blue Cross and Blue Shield Association |
| MAILING ADDRESS | 225 N. Michigan Ave. |
| CITY | Chicago |
| STATE | Illinois |
| STATE/COUNTRY/REGION/JURISDICTION/U.S. TERRITORY | United States |
| ZIP/POSTAL CODE | 60601 |
| XXXX | |
| ATTORNEY SECTION (proposed) | |
| STATEMENT TEXT | By submission of this request, the undersigned appoints the following new attorney, is newly appearing as the attorney, or updates the information of an existing attorney of record: |
| NAME | J. Ryan Hinshaw |
| ATTORNEY BAR MEMBERSHIP NUMBER | XXX |
| YEAR OF ADMISSION | XXXX |
| U.S. STATE/ COMMONWEALTH/ TERRITORY | XX |
| FIRM NAME | Blue Cross and Blue Shield Association |
| STREET | 225 North Michigan Avenue |
| CITY | Chicago |
| STATE | Illinois |
| STATE/COUNTRY/REGION/JURISDICTION/U.S. TERRITORY | United States |
| POSTAL/ZIP CODE | 60601 |
| ryan.hinshaw@bcbsa.com | |
| DOCKET/REFERENCE NUMBER(S) | 10503EF |
| CORRESPONDENCE SECTION (proposed) | |
| NAME | J. Ryan Hinshaw |
| PRIMARY EMAIL ADDRESS FOR CORRESPONDENCE | ryan.hinshaw@bcbsa.com |
| SECONDARY EMAIL ADDRESS(ES) (COURTESY COPIES) | trademarks@bcbsa.com; cynthia.stevens@bcbsa.com |
| DOCKET/REFERENCE NUMBER(S) | 10503EF |
| SIGNATURE SECTION | |
| SIGNATURE | /J. Ryan Hinshaw/ |
| SIGNATORY NAME | J. Ryan Hinshaw |
| SIGNATORY DATE | 05/08/2020 |
| SIGNATORY POSITION | Attorney of record, Illinois bar member |
| AUTHORIZED SIGNATORY | YES |
| FILING INFORMATION SECTION | |
| SUBMIT DATE | Fri May 08 11:01:35 ET 2020 |
| TEAS STAMP | USPTO/CAR-XX.XXX.XXX.XXX- 20200508110135380416-8834 2211-71042d72b69c4d549c3b 6677ab655348bcb5a504c2dc9 ab1963e4082ff4b6623-N/A-N /A-20200508105751441887 |
| 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) |