Change Address or Representation Form

SHITKA

Matt Sullivan

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	88771987
MARK SECTION
MARK	SHITKA (stylized and/or with design, see http://tmng-al.uspto.gov /resting2/api/img/8877198 7/large)
OWNER SECTION(1st owner)(proposed)
STATEMENT TEXT	By submission of this request, the undersigned requests that the following be made of record for the owner/holder:
NAME	Matt Sullivan
PHONE	618-964-5706
EMAIL	XXXX
CORRESPONDENCE SECTION (proposed)
NAME	Matt Sullivan
PRIMARY EMAIL ADDRESS FOR CORRESPONDENCE	Semodelta1@gmail.com
SECONDARY EMAIL ADDRESS(ES) (COURTESY COPIES)	NOT PROVIDED
SIGNATURE SECTION
SIGNATURE	/Matt Sullivan/
SIGNATORY NAME	Matt Sullivan
SIGNATORY DATE	02/18/2020
SIGNATORY POSITION	Owner
AUTHORIZED SIGNATORY	YES
FILING INFORMATION SECTION
SUBMIT DATE	Tue Feb 18 23:21:38 ET 2020
TEAS STAMP	USPTO/PRA-XXXX:XXX:X:X::X X-20200218232138212387-88 771987-710129cad0f8a3a7af 98c8c4de3994f0911711d188e 3994f81a6aca3aca7da6b8-N/ A-N/A-2020021823130021231 9

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: SHITKA (stylized and/or with design, see http://tmng-al.uspto.gov /resting2/api/img/8877198 7/large)
SERIAL NUMBER: 88771987

By submission of this request, the undersigned requests that the following be made of record for the owner/holder:

Owner Section(1st owner) (proposed) :
Matt Sullivan
618-964-5706
XXXXCorrespondence Section (proposed):
Matt Sullivan
PRIMARY EMAIL ADDRESS FOR CORRESPONDENCE: Semodelta1@gmail.com
SECONDARY EMAIL ADDRESS(ES) (COURTESY COPIES): NOT PROVIDED

Signature: /Matt Sullivan/ Date: 02/18/2020
Signatory's Name: Matt Sullivan
Signatory's Position: Owner

Serial Number: 88771987
Internet Transmission Date: Tue Feb 18 23:21:38 ET 2020
TEAS Stamp: USPTO/PRA-XXXX:XXX:X:X::XX-2020021823213
8212387-88771987-710129cad0f8a3a7af98c8c
4de3994f0911711d188e3994f81a6aca3aca7da6
b8-N/A-N/A-20200218231300212319

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