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`Data Element
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`Class Data
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`Mark Data
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`| U Prime/lntemational Class
`I Cl First Use Date
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`ln Another Form
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`Section 2(1)
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`Foreign Reg. Data
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`I [3 Section 2(i) Entire Mark
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`Section 2(0 Limitation Statement
`[ Amended Registerj
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`Cl Foreign Country
`[j——F’oreign Application Number
`[]_—F‘oreign Registration Number
`lj-_Foreign Registration Expiration Date
`Cl
`
`Foreign Reg. Renewal Expiration Date
`
`Owner Data
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`g Owner Name« Address 1
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`_ 3 City
`: :3 Zip Code
`53 Citizenship
`ET-Entity Statement
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`Concurrent Use
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`Prior Registration
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`Attorney
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`Amd/Corr Restr.
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`Prior U.S. Reg.
`Correspondence
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`I
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`Ci Attorney Docket Number
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`BOSALWD HOWARD
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`Cl Goods and Services
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`l3 First Use in Commerce Date
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`El Certification
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`U Pseudo Mark
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`G Design Search Code
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`I
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`Disclaimer
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`Name/Portrait/Consent
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`
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`Ell]CIDEIUDEICIEJEIEJ
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`Section 2(t) in Part
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`Amended Register Date
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`44(d)
`
`Foreign Application Filing Date
`
`Foreign Registration Date
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`Foreign Renewal Reg. Number
`
`Foreign Renewal Reg. Date
`DBA/AKA/TA
`Address 2
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`State
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`Entity
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`Composed of
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