Preliminary Amendment

GEISINGER 65 FORWARD

Geisinger Clinic

Preliminary Amendment

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 1966 (Rev 10/2011)
OMB No. 0651-0050 (Exp 09/20/2020)

Voluntary Amendment


The table below presents the data as entered.

Input Field
Entered
SERIAL NUMBER 88628806
MARK SECTION
MARK http://uspto.report/TM/88628806/mark.png
LITERAL ELEMENT GEISINGER 65 FORWARD
STANDARD CHARACTERS YES
USPTO-GENERATED IMAGE YES
MARK STATEMENT The mark consists of standard characters, without claim to any particular font style, size or color.
SIGNATURE SECTION
DECLARATION SIGNATURE /Matt Rogers/
SIGNATORY'S NAME Matt Rogers
SIGNATORY'S POSITION Assistant General Counsel
SIGNATORY'S PHONE NUMBER 5702716781
DATE SIGNED 10/11/2019
RESPONSE SIGNATURE /Bassam N Ibrahim/ /s/
SIGNATORY'S NAME Bassam N Ibrahim
SIGNATORY'S POSITION attorney
SIGNATORY'S PHONE NUMBER 7038386584
DATE SIGNED 10/11/2019
AUTHORIZED SIGNATORY YES
FILING INFORMATION SECTION
SUBMIT DATE Fri Oct 11 12:01:44 EDT 2019
TEAS STAMP USPTO/PRA-XXX.XXX.XX.X-20
191011120144233311-886288
06-610b536c0709d2fbe06928
12dd37ab83d21a2ebef3b5033
5d7c32db4da6c77a3d-N/A-N/
A-20191011104306626363



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 1966 (Rev 10/2011)
OMB No. 0651-0050 (Exp 09/20/2020)

Voluntary Amendment


To the Commissioner for Trademarks:

Application serial no. 88628806 GEISINGER 65 FORWARD(Standard Characters, see http://uspto.report/TM/88628806/mark.png) has been amended as follows:

SIGNATURE(S)
Declaration Signature

DECLARATION: The signatory being warned that willful false statements and the like are punishable by fine or imprisonment, or both, under 18 U.S.C. § 1001, and that such willful false statements and the like may jeopardize the validity of the application or submission or any registration resulting therefrom, declares that, if the applicant submitted the application or allegation of use (AOU) unsigned, all statements in the application or AOU and this submission based on the signatory's own knowledge are true, and all statements in the application or AOU and this submission made on information and belief are believed to be true.

STATEMENTS FOR UNSIGNED SECTION 1(a) APPLICATION/AOU: If the applicant filed an unsigned application under 15 U.S.C. §1051(a) or AOU under 15 U.S.C. §1051(c), the signatory additionally believes that: the applicant is the owner of the mark sought to be registered; the mark is in use in commerce and was in use in commerce as of the filing date of the application or AOU on or in connection with the goods/services/collective membership organization in the application or AOU; the original specimen(s), if applicable, shows the mark in use in commerce as of the filing date of the application or AOU on or in connection with the goods/services/collective membership organization in the application or AOU; for a collective trademark, collective service mark, collective membership mark application, or certification mark application, the applicant is exercising legitimate control over the use of the mark in commerce and was exercising legitimate control over the use of the mark in commerce as of the filing date of the application or AOU; for a certification mark application, the applicant is not engaged in the production or marketing of the goods/services to which the mark is applied, except to advertise or promote recognition of the certification program or of the goods/services that meet the certification standards of the applicant. To the best of the signatory's knowledge and belief, no other persons, except, if applicable, authorized users, members, and/or concurrent users, have the right to use the mark in commerce, either in the identical form or in such near resemblance as to be likely, when used on or in connection with the goods/services/collective membership organization of such other persons, to cause confusion or mistake, or to deceive.

STATEMENTS FOR UNSIGNED SECTION 1(b)/SECTION 44 APPLICATION AND FOR SECTION 66(a) COLLECTIVE/CERTIFICATION MARK APPLICATION: If the applicant filed an unsigned application under 15 U.S.C. §§ 1051(b), 1126(d), and/or 1126(e), or filed a collective/certification mark application under 15 U.S.C. §1141f(a), the signatory additionally believes that: for a trademark or service mark application, the applicant is entitled to use the mark in commerce on or in connection with the goods/services specified in the application; the applicant has a bona fide intention to use the mark in commerce and had a bona fide intention to use the mark in commerce as of the application filing date; for a collective trademark, collective service mark, collective membership mark, or certification mark application, the applicant has a bona fide intention, and is entitled, to exercise legitimate control over the use of the mark in commerce and had a bona fide intention, and was entitled, to exercise legitimate control over the use of the mark in commerce as of the application filing date; the signatory is properly authorized to execute the declaration on behalf of the applicant; for a certification mark application, the applicant will not engage in the production or marketing of the goods/services to which the mark is applied, except to advertise or promote recognition of the certification program or of the goods/services that meet the certification standards of the applicant. To the best of the signatory's knowledge and belief, no other persons, except, if applicable, authorized users, members, and/or concurrent users, have the right to use the mark in commerce, either in the identical form or in such near resemblance as to be likely, when used on or in connection with the goods/services/collective membership organization of such other persons, to cause confusion or mistake, or to deceive.



Signature: /Matt Rogers/      Date: 10/11/2019
Signatory's Name: Matt Rogers
Signatory's Position: Assistant General Counsel
Signatory's Phone Number: 5702716781


Voluntary Amendment Signature
Signature: /Bassam N Ibrahim/ /s/     Date: 10/11/2019
Signatory's Name: Bassam N Ibrahim
Signatory's Position: attorney

Signatory's Phone Number: 7038386584

The signatory has confirmed that he/she is a U.S.-licensed attorney who is an active member in good standing of the bar of the highest court of a U.S. state (including the District of Columbia and any U.S. Commonwealth or territory); and he/she is currently the owner's/holder's attorney or an associate thereof; and to the best of his/her knowledge, if prior to his/her appointment another U.S.-licensed attorney not currently associated with his/her company/firm previously represented the owner/holder in this matter: the owner/holder has revoked their power of attorney by a signed revocation or substitute power of attorney with the USPTO; the USPTO has granted that attorney's withdrawal request; the owner/holder has filed a power of attorney appointing him/her in this matter; or the owner's/holder's appointed U.S.-licensed attorney has filed a power of attorney appointing him/her as an associate attorney in this matter.

        
Serial Number: 88628806
Internet Transmission Date: Fri Oct 11 12:01:44 EDT 2019
TEAS Stamp: USPTO/PRA-XXX.XXX.XX.X-20191011120144233
311-88628806-610b536c0709d2fbe0692812dd3
7ab83d21a2ebef3b50335d7c32db4da6c77a3d-N
/A-N/A-20191011104306626363



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