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
North American Reishi Ltd
DBA/AKA/TA/Formerly
AKA nammex
*MAILING ADDRESS
926 Joe Road
*CITY
Roberts Creek, BC
*COUNTRY/REGION/JURISDICTION/U.S. TERRITORY
Canada
*ZIP/POSTAL CODE
(Required for U.S. and certain international addresses)
V0N2W6
*EMAIL ADDRESS
XXXX
LEGAL ENTITY INFORMATION
TYPE
corporation
STATE/COUNTRY/REGION/JURISDICTION/U.S. TERRITORY OF INCORPORATION
Canada
GOODS AND/OR SERVICES AND BASIS INFORMATION
INTERNATIONAL CLASS
005
*IDENTIFICATION
Dietary and nutritional supplements containing mushrooms; Fungal extracts sold as a component ingredient of nutritional supplements and
vitamins; Powdered nutritional supplement concentrate
FILING BASIS
SECTION 1(b)
INTERNATIONAL CLASS
029
*IDENTIFICATION
Fungal extracts for use as ingredients of nutritional supplements and vitamins
FILING BASIS
SECTION 1(b)
ADDITIONAL STATEMENTS SECTION
ACTIVE PRIOR REGISTRATION(S)
The applicant claims ownership of active prior U.S. Registration Number(s) 4661349.
ATTORNEY INFORMATION
NAME
Holly J. Bayne, Esq.
ATTORNEY DOCKET NUMBER
BAYNE-201O
ATTORNEY BAR MEMBERSHIP NUMBER
XXX
YEAR OF ADMISSION
XXXX
U.S. STATE/ COMMONWEALTH/ TERRITORY
XX
FIRM NAME
LAW OFFICE OF BAYNE & ASSOCIATES
INTERNAL ADDRESS
Suite 900 South Bldg.
STREET
601 Pennsylvania Ave., NW
CITY
Washington
STATE
District of Columbia
COUNTRY/REGION/JURISDICTION/U.S. TERRITORY
United States
ZIP/POSTAL CODE
20004
PHONE
202-220-3101
FAX
202-639-8238
EMAIL ADDRESS
holly@bayne-associates.com
OTHER APPOINTED ATTORNEY
Christina S. Loza
CORRESPONDENCE INFORMATION
NAME
Holly J. Bayne, Esq.
PRIMARY EMAIL ADDRESS FOR CORRESPONDENCE
holly@bayne-associates.com
SECONDARY EMAIL ADDRESS(ES) (COURTESY COPIES)
tina-pto@lozaip.com
FEE INFORMATION
APPLICATION FILING OPTION
TEAS Standard
NUMBER OF CLASSES
2
APPLICATION FOR REGISTRATION PER CLASS
275
*TOTAL FEES DUE
550
*TOTAL FEES PAID
550
SIGNATURE INFORMATION
SIGNATURE
/Christina S. Loza/
SIGNATORY'S NAME
Christina S. Loza
SIGNATORY'S POSITION
Attorney of Record
SIGNATORY'S PHONE NUMBER
949-705-6777
DATE SIGNED
06/25/2020
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:90021482
Filing Date:06/25/020
To the Commissioner for Trademarks:
MARK: MUSHROOM D2Z (Standard Characters, see mark)
The literal element of the mark consists of MUSHROOM D2Z. The mark consists of standard characters, without claim to any particular font style, size, or color.
The applicant, North American Reishi Ltd, AKA nammex, a corporation of Canada, having an address of
926 Joe Road
Roberts Creek, BC V0N2W6
Canada
XXXX
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:
International Class 005: Dietary and nutritional supplements containing mushrooms; Fungal extracts sold as a component ingredient of nutritional supplements and vitamins; Powdered nutritional
supplement concentrate
Intent to Use: The applicant has a bona fide intention, and is entitled, to use the mark in commerce on or in connection with the identified goods/services.
International Class 029: Fungal extracts for use as ingredients of nutritional supplements and vitamins
Intent to Use: The applicant has a bona fide intention, and is entitled, to use the mark in commerce on or in connection with the identified goods/services.
Claim of Active Prior Registration(s)
The applicant claims ownership of active prior U.S. Registration Number(s) 4661349.
The owner's/holder's proposed attorney information: Holly J. Bayne, Esq.. Other appointed attorneys are Christina S. Loza. Holly J. Bayne, Esq. of LAW OFFICE OF BAYNE & ASSOCIATES, is a
member of the XX bar, admitted to the bar in XXXX, bar membership no. XXX, and the attorney(s) is located at
Suite 900 South Bldg.
601 Pennsylvania Ave., NW
Washington, District of Columbia 20004
United States
202-220-3101(phone)
202-639-8238(fax)
holly@bayne-associates.com
The docket/reference number is BAYNE-201O.
Holly J. Bayne, Esq. 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:
Requirement for Email and Electronic Filing: I understand that a valid email address must be maintained by the applicant owner/holder and the applicant owner's/holder's attorney, if appointed,
and that all official trademark correspondence must be submitted via the Trademark Electronic Application System (TEAS).
A fee payment in the amount of $550 has been submitted with the application, representing payment for 2 class(es).
Declaration
Declaration Signature
Signature: /Christina S. Loza/ Date: 06/25/2020
Signatory's Name: Christina S. Loza
Signatory's Position: Attorney of Record
Payment Sale Number: 90021482
Payment Accounting Date: 06/25/2020
Serial Number: 90021482
Internet Transmission Date: Thu Jun 25 20:55:41 ET 2020
TEAS Stamp: USPTO/BAS-XX.XXX.XX.X-202006252055416441
76-90021482-710511fd2191390e7fa5d7c47132
ca262564b8bd2c1d6a9963fd379f1d3db29fc17-
CC-55400641-20200625155922853184