Application

PTO- 1478

Approved for use through 10/31/2024. OMB 0651-0009

U.S. Patent and Trademark Office; U.S. DEPARTMENT OF COMMERCE Under the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it contains a valid OMB control number

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PTO- 1478

Approved for use through 10/31/2024. OMB 0651-0009

U.S. Patent and Trademark Office; U.S. DEPARTMENT OF COMMERCE Under the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it contains a valid OMB control number

Trademark/Service Mark Application, Principal Register

Serial Number: 97381782

Filing Date: 04/26/2022

To the Commissioner for Trademarks:

MARK: TRUFORM (Standard Characters, see mark)
The literal element of the mark consists of TRUFORM. The mark consists of standard characters, without claim to any particular font style, size, or color.
The applicant, REVENUE WELL SYSTEMS, LLC, a limited liability company legally organized under the laws of Delaware, having an address of
      70 W Madison, Suite 1800
      Chicago, Illinois 60602
      United States
      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 009:  Computer application software and API (application programming interface) for desktop computers and mobile devices, namely, mobile phones and handheld computers, for medical care providers to interactively inform patients of their conditions, treatments options and prognosis to facilitate and document an informed medical consent process and allow the care provider and patient to digitally enter patient information, including the signing of forms for storage and integration with practice management software and other forms of third party electronic health records directly on the mobile device.

In International Class 009, 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 09/01/2002, and first used in commerce at least as early as 09/01/2002, 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) screen shots of the website showing the mark as used in commerce..

Original PDF file:
SPE0-2401490052f933292d54 7a7f5e0e4e-20220421051617 879692_._1.pdf
Converted PDF file(s) (1 page)
Specimen File1
Original PDF file:
SPE0-2401490052f933292d54 7a7f5e0e4e-20220421051617 879692_._2.pdf
Converted PDF file(s) (11 pages)
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Webpage URL: None Provided
Webpage Date of Access: None Provided

International Class 042:  Providing a secure electronic online system featuring technology which allows the generation and updating of medical records from mobile devices, namely, mobile phones and handheld computers, with the streaming and storage of medical and patient information on and between secure servers and practice management software and other forms of third party electronic health records; Providing a web hosting platform for electronic health records with optionally remote access by patients and medical care providers on computing devices and the streaming to and/or uploading from practice management software and third party electronic health records.

In International Class 042, 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 09/01/2002, and first used in commerce at least as early as 09/01/2002, 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) screen shots of the website showing the mark as used in commerce..

Original PDF file:
SPE0-1-2401490052f933292d 547a7f5e0e4e-202204210516 17879692_._1.pdf
Converted PDF file(s) (1 page)
Specimen File1
Original PDF file:
SPE0-1-2401490052f933292d 547a7f5e0e4e-202204210516 17879692_._2.pdf
Converted PDF file(s) (11 pages)
Specimen File1
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Specimen File11
Webpage URL: None Provided
Webpage Date of Access: None Provided



The owner's/holder's proposed attorney information: Taylor Barlow. Other appointed attorneys are Raj Abhyanker, Alexis Campbell, Michael Markos, Jason Bergeron, Jared Coleman, Paul Martello. Taylor Barlow of LegalForce RAPC Worldwide, P.C., is a member of the XX bar, admitted to the bar in XXXX, bar membership no. XXX, and the attorney(s) is located at
      446 E Southern Ave
      Tempe, Arizona 85282
      United States
      650-965-8731(phone)
      650 989-2131(fax)
      docketing@trademarkia.com
The docket/reference number is 2020895.
Taylor Barlow 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:

Taylor Barlow

PRIMARY EMAIL FOR CORRESPONDENCE: docketing@trademarkia.com        SECONDARY EMAIL ADDRESS(ES) (COURTESY COPIES): taylor@trademarkia.com 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 $700 has been submitted with the application, representing payment for 2 class(es).

Declaration

	Basis: If the applicant is filing the application based on use in commerce under 15 U.S.C. § 1051(a): The signatory believes that the applicant is the owner of the trademark/service 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 on or in connection with the goods/services in the application; The specimen(s) shows the mark as used on or in connection with the goods/services in the application and was used on or in connection with the goods/services in the application as of the application filing date; and To the best of the signatory's knowledge and belief, the facts recited in the application are accurate. And/Or If the applicant is filing the application based on an intent to use the mark in commerce under 15 U.S.C. § 1051(b), § 1126(d), and/or § 1126(e): The signatory believes that the applicant is entitled to use the mark in commerce; 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 on or in connection with the goods/services in the application; and To the best of the signatory's knowledge and belief, the facts recited in the application are accurate.
	To the best of the signatory's knowledge and belief, no other persons, except, if applicable, 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 of such other persons, to cause confusion or mistake, or to deceive.
	To the best of the signatory's knowledge, information, and belief, formed after an inquiry reasonable under the circumstances, the allegations and other factual contentions made above have evidentiary support.
	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 all statements made of his/her own knowledge are true and all statements made on information and belief are believed to be true.

Declaration Signature

Signature: /Christopher Fraze/   Date: 04/25/2022
Signatory's Name: Christopher Fraze
Signatory's Position: CEO
Signatory's Phone Number: 7079533641
Signature method: Sent to third party for signature
Payment Sale Number: 97381782
Payment Accounting Date: 04/26/2022

Serial Number: 97381782
Internet Transmission Date: Tue Apr 26 13:22:38 ET 2022
TEAS Stamp: USPTO/BAS-XXXX:XXXX:XXXX:XXXX:XXXX:XXXX:
XXXX:XXXX-20220426132238209549-97381782-
820cd6bb0ee229386a3d41cab35b94a5233884fe
36878151a98e620e0269623acbf-DA-22371027-
20220423061356829469