Multidisciplinary Association of Psychedelic Studies, Inc.
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:88468908
Filing Date:06/11/2019
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.
The mark consists of standard characters, without claim to any particular font style, size, or color.
REGISTER
Principal
APPLICANT INFORMATION
*OWNER OF MARK
Multidisciplinary Association of Psycheldelic Studies, Inc.
*STREET
1115 Mission St.
*CITY
Santa Cruz
*STATE
(Required for U.S. applicants)
California
*COUNTRY
United States
*ZIP/POSTAL CODE
(Required for U.S. and certain international addresses)
95060
WEBSITE ADDRESS
www.psychedelicscience.com
LEGAL ENTITY INFORMATION
*TYPE
non-profit corporation
* STATE/COUNTRY WHERE LEGALLY ORGANIZED
Florida
GOODS AND/OR SERVICES AND BASIS INFORMATION
*INTERNATIONAL CLASS
041
*IDENTIFICATION
Educational services, namely, conducting conferences and workshops in the field of psychotherapy, mental health care,
psychotherapeutic therapies, plant medicine, clinical research, psychological research, medical research, scientific research, pharmaceutical research, psychedelic therapies and distribution of
course material in connection therewith
The mark as used in connection with the promotion and delivery of applicant's services
*INTERNATIONAL CLASS
041
*IDENTIFICATION
Providing a website featuring non-downloadable videos in the field of psychotherapy, mental health care, psychotherapeutic therapies, plant
medicine, clinical research, psychological research, medical research, scientific research, pharmaceutical research, psychedelic therapies
The mark as used in the promotion and delivery of applicant's services
ADDITIONAL STATEMENTS INFORMATION
*TRANSLATION
(if applicable)
*TRANSLITERATION
(if applicable)
*CLAIMED PRIOR REGISTRATION
(if applicable)
*CONSENT (NAME/LIKENESS)
(if applicable)
*CONCURRENT USE CLAIM
(if applicable)
ATTORNEY INFORMATION
NAME
Lara Pearson
FIRM NAME
Brand Geek/ Law Office of Lara Pearson Ltd, PBC
STREET
774 Mays Blvd., No. 10-405
CITY
INCLINE VILLAGE
STATE
Nevada
COUNTRY
United States
ZIP/POSTAL CODE
89451
EMAIL ADDRESS
Lara@BrandGeek.net
AUTHORIZED TO COMMUNICATE VIA EMAIL
Yes
OTHER APPOINTED ATTORNEY
Lara Pearson
CORRESPONDENCE INFORMATION
*NAME
Lara Pearson
FIRM NAME
Brand Geek/ Law Office of Lara Pearson Ltd, PBC
*STREET
774 Mays Blvd., No. 10-405
*CITY
INCLINE VILLAGE
*STATE
(Required for U.S. addresses)
Nevada
*COUNTRY
United States
*ZIP/POSTAL CODE
89451
*EMAIL ADDRESS
Lara@BrandGeek.net; Ramsey@BrandGeek.net
*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
/Richard Doblin/
* SIGNATORY'S NAME
Richard Doblin
* SIGNATORY'S POSITION
Executive Director
SIGNATORY'S PHONE NUMBER
555-555-5555
* DATE SIGNED
06/11/2019
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:88468908
Filing Date:06/11/2019
To the Commissioner for Trademarks:
MARK: Psychedelic Science (Standard Characters, see mark)
The mark in your application is Psychedelic Science.
The applicant, Multidisciplinary Association of Psycheldelic Studies, Inc., a non-profit corporation legally organized under the laws of Florida, having an address of
1115 Mission St.
Santa Cruz, California 95060
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 041: Educational services, namely, conducting conferences and workshops in the field of psychotherapy, mental health care,
psychotherapeutic therapies, plant medicine, clinical research, psychological research, medical research, scientific research, pharmaceutical research, psychedelic therapies and distribution of
course material in connection therewith; Providing a website featuring non-downloadable videos in the field of psychotherapy, mental health care, psychotherapeutic therapies, plant medicine, clinical
research, psychological research, medical research, scientific research, pharmaceutical research, psychedelic 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.
For informational purposes only, applicant's website address is: www.psychedelicscience.com
The applicant's current Attorney Information:
Lara Pearson and Lara Pearson of Brand Geek/ Law Office of Lara Pearson Ltd, PBC 774 Mays Blvd., No. 10-405
INCLINE VILLAGE, Nevada 89451
United States
Lara@BrandGeek.net (authorized)
The applicant's current Correspondence Information:
Lara Pearson
Brand Geek/ Law Office of Lara Pearson Ltd, PBC
774 Mays Blvd., No. 10-405
INCLINE VILLAGE, Nevada 89451
Lara@BrandGeek.net;Ramsey@BrandGeek.net (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: /Richard Doblin/ Date: 06/11/2019
Signatory's Name: Richard Doblin
Signatory's Position: Executive Director
Signatory's Phone Number: 555-555-5555
Payment Sale Number: 88468908
Payment Accounting Date: 06/12/2019
Serial Number: 88468908
Internet Transmission Date: Tue Jun 11 18:54:29 EDT 2019
TEAS Stamp: USPTO/FTK-XX.XXX.XXX.XXX-201906111854292
25452-88468908-6206aac26696dc8d37594bf8d
3bc640e4bbd33b884def3d4b10a914c078a9395-
CC-5834-20190611145430625382