PTO Form 1553 (Rev 9/2005)
`
`OMB No. 0651-0054 (Exp. 10/31/2017)
`
`Trademark/Service Mark Statement of Use
`(15 U.S.C. Section 1051(d))
`
`Input Field
`
`SERIAL NUMBER
`
`LAW OFFICE ASSIGNED
`
`EXTENSION OF USE
`
`MARK SECTION
`
`MARK
`
`LITERAL ELEMENT
`
`STANDARD CHARACTERS
`
`USPTO-GENERATED IMAGE
`
`MARK STATEMENT
`
`OWNER SECTION
`
`NAME
`
`STREET
`
`CITY
`
`STATE
`
`ZIP/POSTAL CODE
`
`COUNTRY
`
`PHONE
`
`FAX
`
`EMAIL
`
`The table below presents the data as entered.
`
`Entered
`
`77832919
`
`LAW OFFICE 117
`
`NO
`
`http://tess2.uspto.gov/ImageAgent/ImageAgentProxy?getImage=77832919
`
`AMYVID
`
`YES
`
`YES
`
`The mark consists of standard characters, without claim to any particular
`font style, size or color.
`
`Avid Radiopharmaceuticals, Inc.
`
`3711 Market Street, 7th floor
`
`Philadelphia
`
`Pennsylvania
`
`19104
`
`United States
`
`317 276 9624
`
`317 276 1919
`
`trademarks@lilly.com
`
`GOODS AND/OR SERVICES SECTION
`
`INTERNATIONAL CLASS
`
`005
`
`CURRENT IDENTIFICATION
`
`Diagnostic agents, preparations and substances for medical purposes;
`diagnostic scanning agents for medical use, namely, diagnostic scanning
`agents for in vivo use; radiopharmaceutical diagnostic preparations for
`medical use; radiopharmaceutical diagnostic preparations for use in the
`diagnosis of neurodegenerative amyloid diseases
`
`GOODS OR SERVICES
`
`KEEP ALL LISTED
`
`FIRST USE ANYWHERE DATE
`
`FIRST USE IN COMMERCE DATE
`
`SPECIMEN FILE NAME(S)
`
`06/30/2012
`
`06/30/2012
`
`\\TICRS\EXPORT16\IMAGEOUT 16\778\329\77832919\xml4\
`SOU0002.JPG
`
`SPECIMEN DESCRIPTION
`
`Product label
`
`

`

`REQUEST TO DIVIDE
`
`PAYMENT SECTION
`
`NUMBER OF CLASSES IN USE
`
`SUBTOTAL AMOUNT [ALLEGATION OF USE FEE]
`
`TOTAL AMOUNT
`
`SIGNATURE SECTION
`
`DECLARATION SIGNATURE
`
`SIGNATORY'S NAME
`
`SIGNATORY'S POSITION
`
`DATE SIGNED
`
`SIGNATORY'S PHONE NUMBER
`
`FILING INFORMATION
`
`SUBMIT DATE
`
`TEAS STAMP
`
`NO
`
`1
`
`100
`
`100
`
`/reljr44/
`
`Robert E. Lee, Jr.
`
`Assistant General Patent Counsel, Eli Lilly and Company, an Authorized
`Representative on behalf of Avid Radiopharmaceuticals, Inc.
`
`04/24/2013
`
`317 276 9624
`
`Wed Apr 24 13:31:30 EDT 2013
`
`USPTO/SOU-XX.XXX.XX.XX-20
`130424133130064622-778329
`19-500695537f328ec753cef6
`3eaca464a8ca2567db0ec7024
`0c579f93695e5c0-DA-10202-
`20130424131951695411
`
`

`

`PTO Form 1553 (Rev 9/2005)
`
`OMB No. 0651-0054 (Exp. 10/31/2017)
`
`Trademark/Service Mark Statement of Use
`(15 U.S.C. Section 1051(d))
`
`To the Commissioner for Trademarks:
`MARK:(cid:160)AMYVID(Standard Characters, see http://tess2.uspto.gov/ImageAgent/ImageAgentProxy?getImage=77832919)
`SERIAL NUMBER:(cid:160)77832919
`
`The applicant, Avid Radiopharmaceuticals, Inc., having an address of
`(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)3711 Market Street, 7th floor
`(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)Philadelphia, Pennsylvania 19104
`(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)United States
`is submitting the following allegation of use information:
`
`For International Class 005:
`Current identification: Diagnostic agents, preparations and substances for medical purposes; diagnostic scanning agents for medical use, namely,
`diagnostic scanning agents for in vivo use; radiopharmaceutical diagnostic preparations for medical use; radiopharmaceutical diagnostic
`preparations for use in the diagnosis of neurodegenerative amyloid diseases
`
`The mark is in use in commerce on or in connection with all of the goods/services, or to indicate membership in the collective organization listed
`in the application or Notice of Allowance or as subsequently modified for this specific class.
`
`The mark was first used by the applicant, or the applicant's related company, licensee, or predecessor in interest at least as early as 06/30/2012,
`and first used in commerce at least as early as 06/30/2012, and is now in use in such commerce. The applicant is submitting one specimen for the
`class showing the mark as used in commerce on or in connection with any item in the class, consisting of a(n) Product label.
`Specimen File1
`
`The applicant is not filing a Request to Divide with this Allegation of Use form.
`
`A fee payment in the amount of $100 will be submitted with the form, representing payment for the allegation of use for 1 class.
`
`Declaration
`
`Applicant requests registration of the above-identified trademark/service mark in the United States Patent and Trademark Office on the Principal
`Register established by the Act of July 5, 1946 (15 U.S.C. Section 1051 et seq., as amended). Applicant is the owner of the mark sought to be
`registered, and is using 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.
`
`The undersigned, being hereby warned that willful false statements and the like so made are punishable by fine or imprisonment, or both, under
`18 U.S.C. Section 1001, and that such willful false statements may jeopardize the validity of the form or any resulting registration, declares that
`he/she is properly authorized to execute this form on behalf of the applicant; he/she believes the applicant to be the owner of the
`trademark/service mark sought to be registered; and that 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: /reljr44/(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)Date Signed: 04/24/2013
`Signatory's Name: Robert E. Lee, Jr.
`Signatory's Position: Assistant General Patent Counsel, Eli Lilly and Company, an Authorized Representative on behalf of Avid
`Radiopharmaceuticals, Inc.
`Signatory's Phone: 317 276 9624
`
`RAM Sale Number: 77832919
`RAM Accounting Date: 04/24/2013
`
`

`

`Serial Number: 77832919
`Internet Transmission Date: Wed Apr 24 13:31:30 EDT 2013
`TEAS Stamp: USPTO/SOU-XX.XXX.XX.XX-20130424133130064
`622-77832919-500695537f328ec753cef63eaca
`464a8ca2567db0ec70240c579f93695e5c0-DA-1
`0202-20130424131951695411
`
`

`

`

`

`FEE RECORD SHEET
`
`Serial Number:
`
`77832919
`
`RAM Sale Number: 77832919
`
`Total Fees:
`
`$100
`
`RAM Accounting Date: 20130424
`
`Transaction
`
`Transaction
`Date
`
`Fee per
`Class
`
`Total
`Number
`of Classes @
`
`Statement of Use (SOU)
`
`20130424
`
`$100
`
`$100
`
`Transaction Date:
`
`2013 0424
`
`