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
`
`Input Field
`
`REGISTRATION NUMBER
`
`REGISTRATION DATE
`
`SERIAL NUMBER
`
`MARK SECTION
`
`MARK
`
`The table below presents the data as entered.
`
`Entered
`
`1918080
`
`09/12/1995
`
`74571897
`
`Miscellaneous Mark (stylized and/or with design)
`
`CORRESPONDENCE SECTION (current)
`
`NAME
`
`FIRM NAME
`
`STREET
`
`CITY
`
`STATE
`
`POSTAL CODE
`
`COUNTRY
`
`CORRESPONDENCE SECTION (proposed)
`
`NAME
`
`FIRM NAME
`
`INTERNAL ADDRESS
`
`STREET
`
`CITY
`
`STATE
`
`POSTAL CODE
`
`COUNTRY
`
`PHONE
`
`FAX
`
`EMAIL
`
`JOHN FAIRMAN
`
`KANSAS STATE UNIVERSITY
`
`122 ANDERSON HALL
`
`MANHATTAN
`
`Kansas
`
`66506
`
`United States
`
`Michael R. Van Wieren
`
`Learfield Licensing Partners, LLC
`
`Suite 100
`
`442 Century Lane
`
`Holland
`
`Michigan
`
`49423
`
`United States
`
`616-395-0676
`
`616-395-2517
`
`mvanwieren@learfieldlicensing.com;aweiss@learfieldlicensing.com
`
`AUTHORIZED TO COMMUNICATE VIA E-MAIL
`
`Yes
`
`DOCKET/REFERENCE NUMBER
`
`Kansas State Powercat
`
`GOODS AND/OR SERVICES SECTION
`
`INTERNATIONAL CLASS
`
`025
`
`GOODS OR SERVICES
`
`clothing, namely hats, T-shirts, sweat shirts, sweat pants, socks, jackets and
`jerseys
`
`

`

`(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)SPECIMEN FILE NAME(S)
`
`(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)ORIGINAL PDF FILE
`
`(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)CONVERTED PDF FILE(S)
`(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(2 pages)
`
`SPN0-1731452173-20150903113229210103_._class_25_specimen.pdf
`
`\\TICRS\EXPORT16\IMAGEOUT16\745\718\74571897\xml2\S890002.JPG
`
`\\TICRS\EXPORT16\IMAGEOUT16\745\718\74571897\xml2\S890003.JPG
`
`SPECIMEN DESCRIPTION
`
`mark as applied to the goods
`
`OWNER SECTION (current)
`
`NAME
`
`STREET
`
`CITY
`
`STATE
`
`ZIP/POSTAL CODE
`
`COUNTRY
`
`OWNER SECTION (proposed)
`
`NAME
`
`STREET
`
`CITY
`
`STATE
`
`ZIP/POSTAL CODE
`
`COUNTRY
`
`PHONE
`
`EMAIL
`
`Kansas State University
`
`122 Anderson Hall
`
`Manhattan
`
`Kansas
`
`66506
`
`United States
`
`Kansas State University
`
`1800 College Ave.
`
`Manhattan
`
`Kansas
`
`66502
`
`United States
`
`785-532-6269
`
`mvanwieren@learfieldlicensing.com
`
`AUTHORIZED TO COMMUNICATE VIA E-MAIL
`
`Yes
`
`LEGAL ENTITY SECTION (current)
`
`TYPE
`
`NOT-FOR-PROFIT ASSOCIATION
`
`STATE/COUNTRY WHERE LEGALLY ORGANIZED Kansas
`
`LEGAL ENTITY SECTION (proposed)
`
`TYPE
`
`STATE/COUNTRY OF INCORPORATION
`
`corporation
`
`Kansas
`
`PAYMENT SECTION
`
`NUMBER OF CLASSES
`
`NUMBER OF CLASSES PAID
`
`SUBTOTAL AMOUNT
`
`TOTAL FEE PAID
`
`SIGNATURE SECTION
`
`SIGNATURE
`
`SIGNATORY'S NAME
`
`SIGNATORY'S POSITION
`
`1
`
`1
`
`400
`
`400
`
`/Michael R. Van Wieren/
`
`Michael R. Van Wieren
`
`Attorney of Record, Texas bar member
`
`(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)
`

`

`DATE SIGNED
`
`SIGNATORY'S PHONE NUMBER
`
`PAYMENT METHOD
`
`09/08/2015
`
`616-395-0676
`
`CC
`
`SUBMIT DATE
`
`TEAS STAMP
`
`FILING INFORMATION
`
`Tue Sep 08 09:49:26 EDT 2015
`
`USPTO/S08N09-XXX.XX.XX.XX
`X-20150908094926845330-19
`18080-540a15460e65ffa7081
`49f3d5eff85c2af020432c2d4
`b2831d6a558613fea0e05-CC-
`23069-2015090809180365349
`8
`
`

`

`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:(cid:160)1918080
`REGISTRATION DATE:(cid:160)09/12/1995
`
`MARK: (Stylized and/or with Design, Miscellaneous Mark)
`
`The owner, Kansas State University, a corporation of Kansas, having an address of
`(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)1800 College Ave.
`(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)Manhattan, Kansas 66502
`(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)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 025, 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: clothing, namely hats, T-shirts, sweat shirts, sweat
`pants, socks, jackets and jerseys ; 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) mark as applied to the goods.
`
`Original PDF file:
`SPN0-1731452173-20150903113229210103_._class_25_specimen.pdf
`Converted PDF file(s) (2 pages)
`Specimen File1
`Specimen File2
`The registrant's current Correspondence Information: JOHN FAIRMAN of (cid:160)KANSAS STATE UNIVERSITY
`(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)122 ANDERSON HALL
`(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)MANHATTAN, Kansas (KS) 66506
`(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)United States
`
`The registrant's proposed Correspondence Information: Michael R. Van Wieren of (cid:160)Learfield Licensing Partners, LLC
`(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)Suite 100
`(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)442 Century Lane
`(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)Holland, Michigan (MI) 49423
`(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)United States
`The docket/reference number is Kansas State Powercat.
`
`The phone number is 616-395-0676.
`
`The fax number is 616-395-2517.
`
`The email address is mvanwieren@learfieldlicensing.com;aweiss@learfieldlicensing.com.
`
`A fee payment in the amount of $400 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/services, or to
`indicate membership in the collective membership organization identified above, as evidenced by the attached specimen(s) showing the mark as
`
`

`

`used in commerce.
`
`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 this submission, 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.
`
`Section 9: Application for Renewal
`The registrant requests that the registration be renewed for the goods/services/collective organization identified above.
`
`Signature: /Michael R. Van Wieren/(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)Date: 09/08/2015
`Signatory's Name: Michael R. Van Wieren
`Signatory's Position: Attorney of Record, Texas bar member
`Signatory's Phone Number: 616-395-0676
`
`Serial Number: 74571897
`Internet Transmission Date: Tue Sep 08 09:49:26 EDT 2015
`TEAS Stamp: USPTO/S08N09-XXX.XX.XX.XXX-2015090809492
`6845330-1918080-540a15460e65ffa708149f3d
`5eff85c2af020432c2d4b2831d6a558613fea0e0
`5-CC-23069-20150908091803653498
`
`

`

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`

`ROUTING SHEET TO POST REGISTRATION (PRU)
`
`Registration Number?
`
`1913030
`
`Serial Number:
`
`74571897
`
`RAM Sale Number: 1918080
`
`RAM Accounting Date: 20150908
`
`Total Fees:
`
`$400
`
`Note: Process in accordance with Post Registration Standard Operating Procedure (SOP)
`
`Transaction
`
`Transaction
`Date
`
`Fee per
`Class
`
`Number
`of Classes
`
`Number of
`Classes Paid
`
`§8 affidavit
`Application for Renewal (§9)
`
`20150908
`20150908
`
`$100
`$3 00
`
`Physical Location: 900 - FILE REPOSITORY (FRANCONIA)
`
`Lost Case Flag: False
`
`In TICRS (AM—FLG—IN—TICRS): True
`
`Transaction Date:
`
`20150908
`
`