`El AMENDMENT STAGE”/A
`CHANGE
`Name:_Deleaches Young
`L.O. __l05
`Date 3 "
`
`' D 3
`
`PUBLICATION/REGISTRATION STAGE
`Serial No.
`‘
`l
`V-I
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`INSTRUCTIONS: Place a cieck mark in the appropriate column and/or box to indicate which data elements have been amended/coded.
`‘K
`HN95.5
`/5 MH\/
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`Le al Instrument
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`Class Data
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`‘
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`.(D
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`El Prime/International Class
`_
`El First Use Date
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`El
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`El
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`In Another Form
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`lb
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`I
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`Data Element
`D Goods and Services
`_
`_
`El First Use in Commerce Date I
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`A
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`C] Certification
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`A El Pseudo Mark
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`l.__l Design Search Code
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`El Disclaimer
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`El Name/Portrait/Consent
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`Section 2(1) in Part
`Amended Register Date
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`>
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`Foreign -Application Filing Date
`Foreign Registration Date
`Foreign Renewal Reg. Number
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`Mark Data
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`El Word Mark
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`Misc. Mark Data
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`Section i2(f)
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`.
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`Foreign Reg. Data ’
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`K El Mark Drawing Code
`El Scan Sub Drawing
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`El Mark Description
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`Cl Lining/Stippling
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`; El Translation
`El Section 2(i) Entire Mark
`El Section 2(f) Limitation Statement
`El Amended Register
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`El Foreign Country
`El Foreign Application Number
`El ’ Foreign Registration Number
`El Foreign Registration Expiration Date
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`’ Owner Data
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`El Foreign Reg. Renewal Expiration Date
`El Owner Name
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`Foreign Renewal Reg Date
`DBA/AKA/TA
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`El Address 1
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`El City
`El Zip Code
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`g
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`El Citizenship
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`F
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`Cl Entity Statement
`El Assignment(s)/Name Change
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`El Concurrent Use
`Prior Registratio
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`El Attorney
`El Attorney Docket Number
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`Address 2
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`State
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`Composed of
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`g
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`I
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`El Domestic Representative
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`Amd/Corr Restr.
`Prior U.S. Reg.
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`Correspondence
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`El, Correspondence Firm Name/Address
`I certify that all corrections have been entered in accordance with text editing guidelines.
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`M
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`Other:
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`D.Young
`LIE