Change Address or Representation Form

CARDIAC INTELLIGENCE

Medical Companion, LLC

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 2196 (Rev 09/2005)
OMB No. 0651-0056 (Exp 11/30/2020)

Change Address or Representation Form


The table below presents the data as entered.

Input Field Entered
SERIAL NUMBER 88449112
LAW OFFICE ASSIGNED LAW OFFICE 119
MARK SECTION
MARK CARDIAC INTELLIGENCE (standard characters, see http://uspto.report/TM/88449112/mark.png)
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 Medical Companion, LLC
EMAIL XXXX
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 Pam Kohli Jacobson
ATTORNEY BAR MEMBERSHIP NUMBER XXX
YEAR OF ADMISSION XXXX
U.S. STATE/ COMMONWEALTH/ TERRITORY XX
FIRM NAME K&L GATES LLP
OTHER APPOINTED ATTORNEY(S) Ryan Edmondson, Michael Meredith, Katie Christensen
STREET 925 4TH AVE., STE 2900
CITY SEATTLE
STATE Washington
STATE/COUNTRY/REGION/JURISDICTION/U.S. TERRITORY United States
POSTAL/ZIP CODE 98104
PHONE 206-370-7605
FAX 206-623-7022
EMAIL pam.jacobson@klgates.com
DOCKET/REFERENCE NUMBER(S) 207075700055
CORRESPONDENCE SECTION (proposed)
NAME Pam Kohli Jacobson
PRIMARY EMAIL ADDRESS FOR CORRESPONDENCE pam.jacobson@klgates.com
SECONDARY EMAIL ADDRESS(ES) (COURTESY COPIES) mpirikIPTeam@klgates.com; SETrademarks@klgates.com
DOCKET/REFERENCE NUMBER(S) 207075700055
SIGNATURE SECTION
SIGNATURE /Pam Kohli Jacobson/
SIGNATORY NAME Pam Kohli Jacobson
SIGNATORY DATE 02/21/2020
SIGNATORY POSITION Attorney of record, Washington bar member
SIGNATORY PHONE NUMBER 206.623.7022
AUTHORIZED SIGNATORY YES
FILING INFORMATION SECTION
SUBMIT DATE Fri Feb 21 16:49:43 ET 2020
TEAS STAMP USPTO/ROA-XXX.XXX.XX.X-20
200221164943973568-884491
12-7103c3e2d73dbce5127e9f
9de4ba2734334f28b339b617c
4ecc99332d4dee42093-N/A-N
/A-20200221150032177613



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 2196 (Rev 09/2005)
OMB No. 0651-0056 (Exp 11/30/2020)


Change Address or Representation Form


To the Commissioner for Trademarks:

MARK: CARDIAC INTELLIGENCE (standard characters, see http://uspto.report/TM/88449112/mark.png)
SERIAL NUMBER: 88449112



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.

Attorney Section (proposed):
Pam Kohli Jacobson of K&L GATES LLP
XX bar, admitted in XXXX, bar membership no. XXX, is located at
925 4TH AVE., STE 2900
SEATTLE, Washington 98104
United States
206-370-7605
206-623-7022
pam.jacobson@klgates.com
Other Appointed Attorney(s): Ryan Edmondson, Michael Meredith, Katie Christensen
Docket Reference Number(s): 207075700055Pam Kohli Jacobson 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 (proposed):
Pam Kohli Jacobson
PRIMARY EMAIL ADDRESS FOR CORRESPONDENCE: pam.jacobson@klgates.com
SECONDARY EMAIL ADDRESS(ES) (COURTESY COPIES): mpirikIPTeam@klgates.com; SETrademarks@klgates.com
Docket Reference Number(s): 207075700055




Signature: /Pam Kohli Jacobson/      Date: 02/21/2020
Signatory's Name: Pam Kohli Jacobson
Signatory's Position: Attorney of record, Washington bar member
Signatory's Phone Number: 206.623.7022

Serial Number: 88449112
Internet Transmission Date: Fri Feb 21 16:49:43 ET 2020
TEAS Stamp: USPTO/ROA-XXX.XXX.XX.X-20200221164943973
568-88449112-7103c3e2d73dbce5127e9f9de4b
a2734334f28b339b617c4ecc99332d4dee42093-
N/A-N/A-20200221150032177613



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