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:90403238
Filing Date:12/22/2020
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
CleanSlate Centers, Inc.
INTERNAL ADDRESS
c/o Wyatt Tarrant & Combs -M Coughlin
*MAILING ADDRESS
400 West Market Street, Suite 2000
*CITY
Louisville
*STATE
(Required for U.S. applicants)
Kentucky
*COUNTRY/REGION/JURISDICTION/U.S. TERRITORY
United States
*ZIP/POSTAL CODE
(Required for U.S. and certain international addresses)
40202
*DOMICILE
XXXX
PHONE
502-562-7561
*EMAIL ADDRESS
XXXX
LEGAL ENTITY INFORMATION
*TYPE
CORPORATION
* STATE/COUNTRY/REGION/JURISDICTION/U.S. TERRITORY OF INCORPORATION
Delaware
GOODS AND/OR SERVICES AND BASIS INFORMATION
*INTERNATIONAL CLASS
044
*IDENTIFICATION
Addiction treatment services; Behavioral health services; Medical services, namely, integrated medical and behavioral health care
services; Mental health services; Chemical dependency and substance abuse treatment services; Providing a web site featuring information in the field of mental health and wellness; Rehabilitation
for substance abuse patients
Photo of entry door to one of the facility locations; screenshots taken from website showing mark prominently displayed in connection
with the services (Accessed 12/8/2020; www.cleanslatecenters.com)
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
Michelle Browning Coughlin
ATTORNEY DOCKET NUMBER
617465.03
ATTORNEY BAR MEMBERSHIP NUMBER
XXX
YEAR OF ADMISSION
XXXX
U.S. STATE/ COMMONWEALTH/ TERRITORY
XX
FIRM NAME
Wyatt Tarrant & Combs LLP
STREET
400 West Market Street, Suite 2000
CITY
Louisville
STATE
Kentucky
COUNTRY/REGION/JURISDICTION/U.S. TERRITORY
United States
ZIP/POSTAL CODE
40202
PHONE
502-562-7561
FAX
502-589-0309
EMAIL ADDRESS
mcoughlin@wyattfirm.com
OTHER APPOINTED ATTORNEY
Matthew Williams, Julie Laemmle Watts, Alexa Elder
CORRESPONDENCE INFORMATION
NAME
Michelle Browning Coughlin
PRIMARY EMAIL ADDRESS FOR CORRESPONDENCE
mcoughlin@wyattfirm.com
SECONDARY EMAIL ADDRESS(ES) (COURTESY COPIES)
dlaney@wyattfirm.com; TRADEMARKS@WYATTFIRM.COM
FEE INFORMATION
APPLICATION FILING OPTION
TEAS Plus
NUMBER OF CLASSES
1
APPLICATION FOR REGISTRATION PER CLASS
225
*TOTAL FEES DUE
225
*TOTAL FEES PAID
225
SIGNATURE INFORMATION
* SIGNATURE
/MBC/
* SIGNATORY'S NAME
Michelle Browning Coughlin
* SIGNATORY'S POSITION
Attorney of record, Kentucky bar member
SIGNATORY'S PHONE NUMBER
502-562-7561
* DATE SIGNED
12/22/2020
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
TEAS Plus Application
Serial Number:90403238
Filing Date:12/22/2020
To the Commissioner for Trademarks:
MARK: CLEANSLATE (Standard Characters, see mark)
The literal element of the mark consists of CLEANSLATE. The mark consists of standard characters, without claim to any particular font style, size, or color.
The applicant, CleanSlate Centers, Inc., a corporation of Delaware, having an address of
c/o Wyatt Tarrant & Combs -M Coughlin
400 West Market Street, Suite 2000
Louisville, Kentucky 40202
United States
502-562-7561(phone)
XXXX
Domiciled at: 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:
For specific filing basis information for each item, you must view the display within the Input Table.
International Class 044: Addiction treatment services; Behavioral health services; Medical services, namely, integrated medical and behavioral health care services; Mental health services;
Chemical dependency and substance abuse treatment services; Providing a web site featuring information in the field of mental health and wellness; Rehabilitation for substance abuse patients
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.
In International Class 044, the mark was first used by the applicant or the applicant's related company or licensee predecessor in interest at least as early as 12/00/2009, and first used in commerce
at least as early as 12/00/2009, 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) Photo of entry door to one of the facility locations; screenshots taken from website showing mark prominently displayed in connection with the
services (Accessed 12/8/2020; www.cleanslatecenters.com). JPG file(s): Specimen File1 Original PDF file: SPE0-20887237201-20201208 101229519805_._CLEANSLATE
_SPECIMEN.pdf Converted PDF file(s) (3 pages) Specimen File1 Specimen File2 Specimen File3 Original PDF file: SPE0-20887237201-20201208
101229519805_._Our_Approa ch_to_Recovery_specimen.pdf Converted PDF file(s) (1 page) Specimen File1
The owner's/holder's proposed attorney information: Michelle Browning Coughlin. Other appointed attorneys are Matthew Williams, Julie Laemmle Watts, Alexa Elder. Michelle Browning Coughlin of
Wyatt Tarrant & Combs LLP, is a member of the XX bar, admitted to the bar in XXXX, bar membership no. XXX, and the attorney(s) is located at
400 West Market Street, Suite 2000
Louisville, Kentucky 40202
United States
502-562-7561(phone)
502-589-0309(fax)
mcoughlin@wyattfirm.com
The docket/reference number is 617465.03.
Michelle Browning Coughlin 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 $225 has been submitted with the application, representing payment for 1 class(es).
Declaration
Declaration Signature
Signature: /MBC/ Date: 12/22/2020
Signatory's Name: Michelle Browning Coughlin
Signatory's Position: Attorney of record, Kentucky bar member
Signatory's Phone Number: 502-562-7561
Payment Sale Number: 90403238
Payment Accounting Date: 12/22/2020
Serial Number: 90403238
Internet Transmission Date: Tue Dec 22 17:02:34 ET 2020
TEAS Stamp: USPTO/FTK-XXX.XX.XXX.XXX-202012221702340
17631-90403238-7509bfa9b2aa7a9aeed44662b
6f17b419c808e874af8f7979f3eaba4f01e488a4
3-DA-02333624-20201222164118851706