PTO Form 1963 (Rev 5/2006)
`
`OMB No. 0651-0055 (Exp 10/31/2008)
`
`Combined Declaration of Use In Commerce & Application For Renewal of Registration of
`A Mark Under Sections 8 & 9
`
`The table below presents the data as entered.
`
`Entered
`
`1918080
`
`09/12/1995
`
`74571897
`
`Design only
`
`Input Field
`
`REGISTRATION NUMBER
`
`REGISTRATION DATE
`
`SERIAL NUMBER
`
`MARK SECTION
`
`MARK
`
`OWNER SECTION (no change)
`
`DESIGN MARK(cid:160)FILE NAME(S)
`
`http://tess2.uspto.gov/Im ageAgent/ImageAgentProxy? getImage=74571897
`
`GOODS AND/OR SERVICES SECTION
`
`INTERNATIONAL CLASS
`
`KEEP EXISTING GOODS AND/OR SERVICES
`
`025
`
`YES
`
`SPECIMEN(cid:160)FILE NAME(S)
`
`SPECIMEN DESCRIPTION
`
`PAYMENT SECTION
`
`NUMBER OF CLASSES
`
`NUMBER OF CLASSES PAID
`
`SUBTOTAL AMOUNT
`
`TOTAL AMOUNT
`
`SIGNATURE SECTION
`
`SIGNATURE
`
`SIGNATORY NAME
`
`SIGNATORY DATE
`
`SIGNATORY POSITION
`
`FILING INFORMATION
`
`SUBMIT DATE
`
`TEAS STAMP
`
`\\TICRS\EXPORT9\IMAGEOUT9 \745\718\74571897\xml1\S8 90002.JPG
`
`Specimen consists of a shirt on which the mark is used.
`
`1
`
`1
`
`500
`
`500
`
`/tami l breymeyer/
`
`Tami L. Breymeyer
`
`08/10/2005
`
`Director of Licensing
`
`Thu Aug 11 08:42:58 EDT 2005
`
`USPTO/S08N09-XXXXXXXXXXX-
`20050811084258684002-1918
`080-2009fe187fcb55f2fcfbf
`cb6853dae28ff4-CC-1000-20
`050810164832239026
`
`

`
`PTO Form 1963 (Rev 5/2006)
`
`OMB No. 0651-0055 (Exp 10/31/2008)
`
`Combined Declaration of Use In Commerce & Application For Renewal of Registration of A Mark Under Sections
`8 & 9
`
`To the Commissioner for Trademarks:
`
`REGISTRATION NUMBER:(cid:160)1918080
`REGISTRATION DATE:(cid:160)09/12/1995
`
`MARK: Design only
`
`The owner, Kansas State University, residing at 122 Anderson Hall, Manhattan, KS US 66506, is using the mark in commerce on or in
`connection with the goods and /or services as follows:
`
`For International Class 025, the owner is using or is using through a related company or licensee the mark in commerce on or in connection with
`all goods and/or services listed in the existing registration.
`
`The owner is submitting one specimen for each class showing the mark as used in commerce on or in connection with any item in the class of
`listed goods and/or services , consisting of a(n) Specimen consists of a shirt on which the mark is used..
`Specimen-1
`
`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 in Commerce
`The owner is using or is using through a related company or licensee the mark in commerce on or in connection with the goods/services
`identified above, as evidenced by the attached specimen(s) showing the mark as used in commerce.
`
`Section 9: Application for Renewal
`The registrant requests that the registration be renewed for the goods and/or services identified above.
`
`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.
`
`Signature: /tami l breymeyer/(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)Date: 08/10/2005
`Signatory's Name: Tami L. Breymeyer
`Signatory's Position: Director of Licensing
`
`RAM Sale Number: 1000
`RAM Accounting Date: 08/11/2005
`
`Serial Number: 74571897
`Internet Transmission Date: Thu Aug 11 08:42:58 EDT 2005
`TEAS Stamp: USPTO/S08N09-XXXXXXXXXXX-200508110842586
`84002-1918080-2009fe187fcb55f2fcfbfcb685
`3dae28ff4-CC-1000-20050810164832239026
`
`

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`Address $3http:,I',I'catscloset.com,I'cgi-lJin,I'shopper.e><e?preaI:lcl=actionaakey=shirtmD4-D6U5&re|‘erence=,I'cgi-bin,I'shopper.e>ce°!o3Fsearch°.-'o3Daction°xl
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`Price:$-45.00
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`
`ROUTING SHEET TO POST REGISTRATION (PRU)
`
`R9giStI'ati011 Nllmbefi
`
`1913080
`
`RAM
`
`Serial Number:
`
`74571897
`
`H||1H||1|1|l 1H|||\1||H|1|l|1||H||l
`
`RAM Accounting Date: 20050811
`
`Total Fees:
`
`$500
`
`Note: Process in accordance with Post Registration Standard Operating Procedure (SOP)
`
`Transaction
`
`Transaction
`Date
`
`Fee per
`Class
`
`Total
`Number
`of Classes @
`
`§8 affidavit
`Application for Renewal (§9)
`
`20050811
`2005081 1
`
`$100
`$400
`
`$100
`$400
`
`Physical Location: 900 - FILE REPOSITORY (FRANCONIA)
`
`Lost Case Flag: False
`
`In TICRS (AM-FLG-IN-TICRS): False
`
`Transaction Date:
`
`20050811