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
The mark consists of standard characters, without claim to any particular font style, size, or color.
REGISTER
Principal
APPLICANT INFORMATION
*OWNER OF MARK
FOR MAMA, LLC
*STREET
1610 Montana Avenue
*CITY
Santa Monica
*STATE
(Required for U.S. applicants)
California
*COUNTRY
United States
*ZIP/POSTAL CODE
(Required for U.S. and certain international addresses)
90403
PHONE
424-231-2868
EMAIL ADDRESS
lmlimesq@gmail.com
WEBSITE ADDRESS
www.formarestaurant.com
LEGAL ENTITY INFORMATION
TYPE
limited liability company
STATE/COUNTRY WHERE LEGALLY ORGANIZED
California
GOODS AND/OR SERVICES AND BASIS INFORMATION
INTERNATIONAL CLASS
043
*IDENTIFICATION
Restaurant and bar services; Restaurant and café services; Restaurant and catering services; Restaurant services; Restaurant services,
including sit-down service of food and take-out restaurant services; Restaurant services, namely, providing of food and beverages for consumption on and off the premises
The mark FORMA as shown on lunch and dinner menus used in business and available through Applicant website
www.formarestaurant.com
ATTORNEY INFORMATION
NAME
Lydia M. Lim
ATTORNEY BAR MEMBERSHIP NUMBER
XXX
YEAR OF ADMISSION
XXXX
U.S. STATE/ COMMONWEALTH/ TERRITORY
XX
STREET
2811 3rd Street #3
CITY
Santa Monica
STATE
California
COUNTRY
United States
ZIP/POSTAL CODE
90405
PHONE
310-801-7960
EMAIL ADDRESS
LMLimEsq@Gmail.com
AUTHORIZED TO COMMUNICATE VIA EMAIL
Yes
CORRESPONDENCE INFORMATION
NAME
Lydia M. Lim
STREET
2811 3rd Street #3
CITY
Santa Monica
STATE
California
COUNTRY
United States
ZIP/POSTAL CODE
90405
PHONE
310-801-7960
*EMAIL ADDRESS
LMLimEsq@Gmail.com; sabatini.la@gmail.com
*AUTHORIZED TO COMMUNICATE VIA EMAIL
Yes
FEE INFORMATION
APPLICATION FILING OPTION
TEAS RF
NUMBER OF CLASSES
1
APPLICATION FOR REGISTRATION PER CLASS
275
*TOTAL FEE DUE
275
*TOTAL FEE PAID
275
SIGNATURE INFORMATION
SIGNATURE
/Lydia M. Lim/
SIGNATORY'S NAME
Lydia M. Lim
SIGNATORY'S POSITION
Attorney for Applicant
DATE SIGNED
09/10/2019
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
Serial Number:88610872
Filing Date:09/10/2019
To the Commissioner for Trademarks:
MARK: FORMA (Standard Characters, see mark)
The literal element of the mark consists of FORMA. The mark consists of standard characters, without claim to any particular font style, size, or color.
The applicant, FOR MAMA, LLC, a limited liability company legally organized under the laws of California, having an address of
1610 Montana Avenue
Santa Monica, California 90403
United States
424-231-2868(phone)
lmlimesq@gmail.com
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 043: Restaurant and bar services; Restaurant and café services; Restaurant and catering services; Restaurant services; Restaurant services, including sit-down service of
food and take-out restaurant services; Restaurant services, namely, providing of food and beverages for consumption on and off the premises
In International Class 043, the mark was first used by the applicant or the applicant's related company or licensee or predecessor in interest at least as early as 05/01/2016, and first used in
commerce at least as early as 05/01/2016, and is now in use in such commerce. The applicant is submitting one(or more) specimen(s) showing the mark as used in commerce on or in connection with any
item in the class of listed goods/services, consisting of a(n) The mark FORMA as shown on lunch and dinner menus used in business and available through Applicant website www.formarestaurant.com.
For informational purposes only, applicant's website address is: www.formarestaurant.com
The applicant hereby appoints Lydia M. Lim. Lydia M. Lim, is a member of the XX bar, admitted to the bar in XXXX, bar membership no. XXX, is located at
2811 3rd Street #3
Santa Monica, California 90405
United States
310-801-7960(phone)
LMLimEsq@Gmail.com (authorized).
Lydia M. Lim 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.
The applicant's current Correspondence Information:
Email Authorization: I authorize the USPTO to send email correspondence concerning the application to the applicant, the applicant's attorney, or the applicant's domestic representative at the
email address provided in this application. I understand that a valid email 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 Reduced Fee 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 $275 has been submitted with the application, representing payment for 1 class(es).
Declaration
Declaration Signature
Signature: /Lydia M. Lim/ Date: 09/10/2019
Signatory's Name: Lydia M. Lim
Signatory's Position: Attorney for Applicant
Payment Sale Number: 88610872
Payment Accounting Date: 09/10/2019
Serial Number: 88610872
Internet Transmission Date: Tue Sep 10 12:54:53 EDT 2019
TEAS Stamp: USPTO/BAS-XXX.XXX.XXX.XX-201909101254537
99142-88610872-610f1851ddae75f187e496165
6a258fdddd1198c93c8cf5773756e50c9e680c1-
CC-54520654-20190910122921502190