PTO Form 1963 (Rev 5/2006)
`
`OMB No. 0651-0055 (Exp 12/31/2011)
`
`Combined Declaration of Use in Commerce & Application for Renewal of Registration of a
`Mark under Sections 8 & 9
`
`Input Field
`
`REGISTRATION NUMBER
`
`REGISTRATION DATE
`
`SERIAL NUMBER
`
`MARK SECTION
`
`MARK
`
`OWNER SECTION (current)
`
`NAME
`
`STREET
`
`CITY
`
`STATE
`
`ZIP/POSTAL CODE
`
`COUNTRY
`
`ATTORNEY SECTION (current)
`
`NAME
`
`FIRM NAME
`
`The table below presents the data as entered.
`
`Entered
`
`2216996
`
`01/12/1999
`
`75298180
`
`MAYO ONE
`
`Mayo Foundation for Medical Education and Research
`
`200 First Street S.W.
`
`Rochester
`
`Minnesota
`
`55905
`
`United States
`
`TRAVIS L. BACHMAN
`
`DORSEY & WHITNEY LLP
`
`INTERNAL ADDRESS
`
`SUITE 1500
`
`STREET
`
`CITY
`
`STATE
`
`POSTAL CODE
`
`COUNTRY
`
`ATTORNEY DOCKET NUMBER
`
`ATTORNEY SECTION (proposed)
`
`NAME
`
`FIRM NAME
`
`50 SOUTH SIXTH STREET
`
`MINNEAPOLIS
`
`Minnesota
`
`55402-1498
`
`United States
`
`13.753
`
`Kari B. Frank
`
`DORSEY & WHITNEY LLP
`
`INTERNAL ADDRESS
`
`SUITE 1500
`
`STREET
`
`CITY
`
`STATE
`
`POSTAL CODE
`
`50 SOUTH SIXTH STREET
`
`MINNEAPOLIS
`
`Minnesota
`
`55402-1498
`
`

`

`COUNTRY
`
`PHONE
`
`FAX
`
`EMAIL
`
`AUTHORIZED TO COMMUNICATE VIA E-MAIL
`
`ATTORNEY DOCKET NUMBER
`
`OTHER APPOINTED ATTORNEY
`
`GOODS AND/OR SERVICES SECTION
`
`INTERNATIONAL CLASS
`
`GOODS OR SERVICES
`
`       SPECIMEN FILE NAME(S)
`
`       ORIGINAL PDF FILE
`
`       CONVERTED PDF FILE(S)
`       (1 page)
`
`SPECIMEN DESCRIPTION
`
`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
`
`PAYMENT METHOD
`
`SUBMIT DATE
`
`TEAS STAMP
`
`United States
`
`(612) 492-6863
`
`(612) 340-8856
`
`ip.docket@dorsey.com
`
`Yes
`
`13.753
`
`Stuart R. Hemphill, Elizabeth C. Buckingham, Jamie Nafziger, Patchen M.
`Haggerty, Jeffrey R. Cadwell, and Kelcey Patrick-Ferree
`
`042
`
`KEEP ALL LISTED
`
`SPN0-1701121251-135739834_._13753-4_Specimen_for_Renewals.pdf
`
`\\TICRS\EXPORT4\IMAGEOUT4\752\981\75298180\xml1\S890002.JPG
`
`image of a page from Registrant's website advertising the services
`
`1
`
`1
`
`500
`
`500
`
`/daniel s goldman/
`
`Daniel S. Goldman
`
`Assistant Secretary and Legal Counsel
`
`11/26/2008
`
`DA
`
`FILING INFORMATION
`
`Wed Nov 26 16:56:20 EST 2008
`
`USPTO/S08N09-XXX.XXX.X.XX
`X-20081126165620089532-22
`16996-400b68f3d88336f8aa4
`29146ab14b614-DA-3784-200
`81122135739834392
`
`

`

`PTO Form 1963 (Rev 5/2006)
`
`OMB No. 0651-0055 (Exp 12/31/2011)
`
`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: 2216996
`REGISTRATION DATE: 01/12/1999
`
`MARK:  MAYO ONE
`
`The owner, Mayo Foundation for Medical Education and Research, having an address of
`      200 First Street S.W.
`      Rochester, Minnesota 55905
`      United States
`is filing a Combined Declaration of Use in Commerce & Application for Renewal of Registration of a Mark under Sections 8 & 9.
`
`For International Class 042, the mark is in use in commerce on or in connection with all goods or services listed in the existing registration for
`this specific class; or, the owner is making the listed excusable nonuse claim.
`
`The owner is submitting one specimen showing the mark as used in commerce on or in connection with any item in this class, consisting of a(n)
`image of a page from Registrant's website advertising the services.
`
`Original PDF file:
`SPN0-1701121251-135739834_._13753-4_Specimen_for_Renewals.pdf
`Converted PDF file(s) (1 page)
`Specimen File1
`
`The registrant hereby appoints Kari B. Frank and Stuart R. Hemphill, Elizabeth C. Buckingham, Jamie Nafziger, Patchen M. Haggerty, Jeffrey R.
`Cadwell, and Kelcey Patrick-Ferree of  DORSEY & WHITNEY LLP
`      SUITE 1500
`      50 SOUTH SIXTH STREET
`      MINNEAPOLIS, Minnesota 55402-1498
`       United States
`to file this Combined Declaration of Use in Commerce & Application for Renewal of Registration of a Mark under Sections 8 & 9 on behalf of
`the registrant.  The attorney docket/reference number is 13.753.
`
`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
`Unless the owner has specifically claimed excusable non-use, the owner, or its related company, is using the mark 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.
`
`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: /daniel s goldman/      Date: 11/26/2008
`Signatory's Name: Daniel S. Goldman
`
`

`

`Signatory's Position: Assistant Secretary and Legal Counsel
`
`Mailing Address (current):
`   DORSEY & WHITNEY LLP
`   50 SOUTH SIXTH STREET
`   MINNEAPOLIS, Minnesota 55402-1498
`
`Mailing Address (proposed):
`   DORSEY & WHITNEY LLP
`   50 SOUTH SIXTH STREET
`   MINNEAPOLIS, Minnesota 55402-1498
`
`Serial Number: 75298180
`Internet Transmission Date: Wed Nov 26 16:56:20 EST 2008
`TEAS Stamp: USPTO/S08N09-XXX.XXX.X.XXX-2008112616562
`0089532-2216996-400b68f3d88336f8aa429146
`ab14b614-DA-3784-20081122135739834392
`
`

`

`Helicopter - Mayo One
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`Page 1 of 1
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`NLAYO CLINIC
`Medical Transport
`
`Helicopter - Mayo One
`
`Mayo One, an emergency medical helicopter service, provides high,
`level critical care and rapid transportation. A helicopter can be in flight
`within minutes of the dispatch call, 24 hours a day, every day.
`
`Mayo One flies within a 200-mile radius of bases at Mayo Clinic in
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`-
`in Eau Claire, Wis Separated by 95 miles, the two bases allow Mayo
`One to serve much of southern Minnesota, western Wisconsin and
`northern Iowa. More than 1,000 flights are made a year.
`
`Minutes From Rochester
`45. 55.
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`Minutes From Eau Claire
`45. 55-
`55
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`Home
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`Air Ambulance - Mayo
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`Helicopter * Mayo One
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`10/27/2008
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`Contact Us
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`Flight Radius from
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`3
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`Fiigm Radius from
`Eau Claire, Wis.
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`Aircraft, aviation crew and
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`operations certificate
`provided by Omniflight
`Helicopters Inc-
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`News
`Mayo One Helicopter to
`Base at Chippewa Valley
`Regional Airport
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`Mayo Clinic‘s Medical
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`Minutes From Mankato
`45 I 55 j 35
`
`25
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`flesMni
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`Flight Radius from
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`

`ROUTING SHEET TO POST REGISTRATION (PRU)
`
`Registration Number:
`
`2216996
`
`RAM Sale Number: 3784
`
`Serial Number:
`
`75298180
`
`l
`
`RAM Accounting Date: 20081128
`
`Total Fees:
`
`$500
`
`Note: Process in accordance with Post Registration Standard Operating Procedure (SOP)
`
`20081126
`
`Transaction
`
`Transaction
`Date
`
`Fee per
`Class
`
`Number
`of Classes
`
`Number of
`Classes Paid
`
`§8 affidavit
`Application for Renewal (§9)
`
`20081126
`20081 126
`
`$100
`$400
`
`Physical Location: 900 - FILE REPOSITORY (FRANCONIA)
`
`Lost Case Flag: False
`
`In TICRS (AM-FLG—IN-TICRS): True
`
`Transaction Date:
`
`