PTO Form 1963 (Rev 5/2006)
`
`OMB No. 0651-0055 (Exp 07/31/2018)
`
`Combined Declaration of Use and/or Excusable Nonuse/Application for Renewal of
`Registration of a Mark under Sections 8 & 9
`
`The table below presents the data as entered.
`
`Input Field
`
`REGISTRATION NUMBER
`
`REGISTRATION DATE
`
`SERIAL NUMBER
`
`MARK SECTION
`
`MARK
`
`ATTORNEY SECTION (current)
`
`NAME
`
`FIRM NAME
`
`INTERNAL ADDRESS
`
`STREET
`
`CITY
`
`STATE
`
`POSTAL CODE
`
`COUNTRY
`
`PHONE
`
`FAX
`
`ATTORNEY SECTION (proposed)
`
`NAME
`
`FIRM NAME
`
`INTERNAL ADDRESS
`
`STREET
`
`CITY
`
`STATE
`
`POSTAL CODE
`
`COUNTRY
`
`PHONE
`
`FAX
`
`EMAIL
`
`Entered
`
`1697898
`
`06/30/1992
`
`73703401
`
`CLEARLY CANADIAN
`
`GREGORY N OWEN
`
`OWEN, WICKERSHAM & ERICKSON, P.C.
`
`455 MARKET ST
`
`SUITE 1910
`
`SAN FRANCISCO
`
`California
`
`94105
`
`United States
`
`415-882-3200
`
`415-882-3232
`
`Shawn R. Farmer
`
`MUSKIN & CUSICK, LLC
`
`100 W. Main Street
`
`Suite 205
`
`Lansdale
`
`Pennsylvania
`
`19446
`
`United States
`
`215 853 8259
`
`775 371 5483
`
`sfarmer@patentstrademarks.com
`
`AUTHORIZED TO COMMUNICATE VIA E-MAIL
`
`DOCKET/REFERENCE NUMBER
`
`Yes
`
`2122-100
`
`

`

`OTHER APPOINTED ATTORNEY
`
`Clinton J. Cusick, Jon H. Muskin
`
`CORRESPONDENCE SECTION (current)
`
`NAME
`
`FIRM NAME
`
`INTERNAL ADDRESS
`
`STREET
`
`CITY
`
`STATE
`
`POSTAL CODE
`
`COUNTRY
`
`PHONE
`
`FAX
`
`CORRESPONDENCE SECTION (proposed)
`
`NAME
`
`FIRM NAME
`
`INTERNAL ADDRESS
`
`STREET
`
`CITY
`
`STATE
`
`POSTAL CODE
`
`COUNTRY
`
`PHONE
`
`FAX
`
`EMAIL
`
`GREGORY N OWEN
`
`OWEN, WICKERSHAM & ERICKSON, P.C.
`
`455 MARKET ST
`
`SUITE 1910
`
`SAN FRANCISCO
`
`California
`
`94105
`
`United States
`
`415-882-3200
`
`415-882-3232
`
`Shawn R. Farmer
`
`MUSKIN & CUSICK, LLC
`
`100 W. Main Street
`
`Suite 205
`
`Lansdale
`
`Pennsylvania
`
`19446
`
`United States
`
`215 853 8259
`
`775 371 5483
`
`sfarmer@patentstrademarks.com
`
`AUTHORIZED TO COMMUNICATE VIA E-MAIL
`
`DOCKET/REFERENCE NUMBER
`
`GOODS AND/OR SERVICES SECTION
`
`INTERNATIONAL CLASS
`
`Yes
`
`2122-100
`
`032
`
`GOODS OR SERVICES
`
`SPECIMEN FILE NAME(S)
`
`SPECIMEN DESCRIPTION
`
`OWNER SECTION (current)
`
`NAME
`
`STREET
`
`CITY
`
`FLAVORED MINERAL WATERS, FRUIT FLAVORED MINERAL
`WATERS, NON-FLAVORED MINERAL WATERS, CARBONATED
`MINERAL WATERS, NON-CARBONATED MINERAL WATERS,
`BOTTLED DRINKING WATERS, SPRING WATERS, SOFT DRINKS
`AND FRUIT JUICES
`
`\\TICRS\EXPORT16\IMAGEOUT 16\737\034\73703401\xml2\
`S890002.JPG
`
`A photo of Applicant's product.
`
`THE CLEARLY FOOD & BEVERAGE COMPANY, INC.
`
`P.O. BOX 325
`
`PERRYSBURG
`
`

`

`STATE
`
`ZIP/POSTAL CODE
`
`COUNTRY
`
`LEGAL ENTITY SECTION (current)
`
`TYPE
`
`STATE/COUNTRY OF INCORPORATION
`
`PAYMENT SECTION
`
`NUMBER OF CLASSES
`
`NUMBER OF CLASSES PAID
`
`SUBTOTAL AMOUNT
`
`TOTAL FEE PAID
`
`SIGNATURE SECTION
`
`SIGNATURE
`
`SIGNATORY'S NAME
`
`SIGNATORY'S POSITION
`
`DATE SIGNED
`
`SIGNATORY'S PHONE NUMBER
`
`PAYMENT METHOD
`
`SUBMIT DATE
`
`TEAS STAMP
`
`Ohio
`
`43551-0325
`
`United States
`
`corporation
`
`Delaware
`
`1
`
`1
`
`500
`
`500
`
`/Robert Khan/
`
`Robert Khan
`
`Chairman & President
`
`06/28/2012
`
`15142689553
`
`CC
`
`FILING INFORMATION
`
`Thu Jun 28 13:26:49 EDT 2012
`
`USPTO/S08N09-XX.X.XXX.XX-
`20120628132649037294-1697
`898-4901eab35a9cfb5399c1b
`ca1e0bd82084-CC-14203-201
`20628121419107818
`
`

`

`PTO Form 1963 (Rev 5/2006)
`
`OMB No. 0651-0055 (Exp 07/31/2018)
`
`Combined Declaration of Use and/or Excusable Nonuse/Application for Renewal of Registration of a Mark under
`Sections 8 & 9
`
`To the Commissioner for Trademarks:
`
`REGISTRATION NUMBER: 1697898
`REGISTRATION DATE: 06/30/1992
`
`MARK: CLEARLY CANADIAN
`
`The owner, THE CLEARLY FOOD & BEVERAGE COMPANY, INC., a corporation of Delaware, having an address of
`      P.O. BOX 325
`      PERRYSBURG, Ohio 43551-0325
`      United States
`is filing a Combined Declaration of Use and/or Excusable Nonuse/Application for Renewal of Registration of a Mark under Sections 8 & 9.
`
`For International Class 032, the mark is in use in commerce on or in connection with all goods/services, or to indicate membership in the
`collective membership organization, listed in the existing registration for this specific class: FLAVORED MINERAL WATERS, FRUIT
`FLAVORED MINERAL WATERS, NON-FLAVORED MINERAL WATERS, CARBONATED MINERAL WATERS, NON-CARBONATED
`MINERAL WATERS, BOTTLED DRINKING WATERS, SPRING WATERS, SOFT DRINKS AND FRUIT JUICES ; or, the owner is making
`the listed excusable nonuse claim.
`
`The owner is submitting one(or more) specimen(s) showing the mark as used in commerce on or in connection with any item in this class,
`consisting of a(n) A photo of Applicant's product..
`Specimen File1
`The registrant's current Attorney Information: GREGORY N OWEN of  OWEN, WICKERSHAM & ERICKSON, P.C.
`      455 MARKET ST
`      SUITE 1910
`      SAN FRANCISCO, California (CA) 94105
`      United States
`
`The registrant's proposed Attorney Information: Shawn R. Farmer of  MUSKIN & CUSICK, LLC
`      100 W. Main Street
`      Suite 205
`      Lansdale, Pennsylvania (PA) 19446
`      United States
`The docket/reference number is 2122-100.
`The Other Appointed Attorney(s): Clinton J. Cusick, Jon H. Muskin.
`
`The phone number is 215 853 8259.
`
`The fax number is 775 371 5483.
`
`The email address is sfarmer@patentstrademarks.com.
`The registrant's current Correspondence Information: GREGORY N OWEN of  OWEN, WICKERSHAM & ERICKSON, P.C.
`      455 MARKET ST
`      SUITE 1910
`      SAN FRANCISCO, California (CA) 94105
`      United States
`
`The registrant's proposed Correspondence Information: Shawn R. Farmer of  MUSKIN & CUSICK, LLC
`      100 W. Main Street
`      Suite 205
`      Lansdale, Pennsylvania (PA) 19446
`      United States
`
`

`

`The docket/reference number is 2122-100.
`
`The phone number is 215 853 8259.
`
`The fax number is 775 371 5483.
`
`The email address is sfarmer@patentstrademarks.com.
`
`A fee payment in the amount of $500 will be submitted with the form, representing payment for 1 class(es), plus any additional grace period fee,
`if necessary.
`
`Declaration
`
`Section 8: Declaration of Use and/or Excusable Nonuse in Commerce
`Unless the owner has specifically claimed excusable nonuse, the mark is in use in commerce on or in connection with the goods and/or services
`identified above, as evidenced by the attached specimen(s) showing the mark as used in commerce.
`
`The undersigned being hereby warned that willful false statements and the like are punishable by fine or imprisonment, or both, under 18 U.S.C.
`Section 1001, and that such willful false statements and the like may jeopardize the validity of this document, declares that he/she is properly
`authorized to execute this document on behalf of the Owner; and all statements made of his/her own knowledge are true and that all statements
`made on information and belief are believed to be true.
`
`Section 9: Application for Renewal
`The registrant requests that the registration be renewed for the goods/services/collective organization identified above.
`
`Signature: /Robert Khan/      Date: 06/28/2012
`Signatory's Name: Robert Khan
`Signatory's Position: Chairman & President
`Signatory's Phone Number: 15142689553
`
`Mailing Address (current):
`   OWEN, WICKERSHAM & ERICKSON, P.C.
`   SUITE 1910
`   SAN FRANCISCO, California 94105
`
`Mailing Address (proposed):
`   MUSKIN & CUSICK, LLC
`   Suite 205
`   Lansdale, Pennsylvania 19446
`
`Serial Number: 73703401
`Internet Transmission Date: Thu Jun 28 13:26:49 EDT 2012
`TEAS Stamp: USPTO/S08N09-XX.X.XXX.XX-201206281326490
`37294-1697898-4901eab35a9cfb5399c1bca1e0
`bd82084-CC-14203-20120628121419107818
`
`

`

`
`
`

`

`ROUTING SHEET TO POST REGISTRATION (PRU)
`
`Registration Number:
`
`1697898
`
`RAM Sale Number: 14203
`
`Serial Number:
`
`73 703 401
`
`|
`
`RAM Accounting Date: 20120628
`
`Total Fees:
`
`$500
`
`Note: Process in accordance with Post Registration Standard Operating Procedure (SOP)
`
`20120628
`
`Transaction
`
`Transaction
`Date
`
`Fee per
`Class
`
`Number
`of Classes
`
`Number of
`Classes Paid
`
`§8 affidavit
`Application for Renewal (§9)
`
`20120628
`20120628
`
`$100
`$400
`
`Physical Location: 900 - FILE REPOSITORY (FRANCONIA)
`
`Lost Case Flag: False
`
`In TICRS (AM-FLG—IN-TICRS): True
`
`Transaction Date:
`
`