PTO Form 1553 (Rev 9/2005)
`
`OMB No. 0651-0054 (Exp. 09/30/2011)
`
`Trademark/Service Mark Request to Divide
`
`The table below presents the data as entered.
`
`Input Field
`
`Entered
`
`SERIAL NUMBER
`
`LAW OFFICE ASSIGNED
`
`EXTENSION OF USE
`
`MARK SECTION
`
`STANDARD CHARACTERS
`
`USPTO-GENERATED IMAGE
`
`LITERAL ELEMENT
`
`REQUEST TO DIVIDE
`
`77731891
`
`LAW OFFICE 110
`
`NO
`
`YES
`
`YES
`
`SALT LIFE
`
`YES
`
`GOOD(S)/SERVICE(S) IN USE
`
`Class 014; Class 043
`
`GOOD(S)/SERVICES INTENT TO USE
`
`Class 003; Class 016; Class 018; Class 021; Class 026; Class 028; Class
`032; class 041
`
`SIGNATURE SECTION
`
`DECLARATION SIGNATURE
`
`SIGNATORY'S NAME
`
`SIGNATORY'S POSITION
`
`DATE SIGNED
`
`REQUEST TO DIVIDE SIGNATURE
`
`SIGNATORY'S NAME
`
`SIGNATORY'S POSITION
`
`DATE SIGNED
`
`AUTHORIZED SIGNATORY
`
`PAYMENT SECTION
`
`NUMBER OF CLASSES IN USE
`
`SUBTOTAL AMOUNT [ALLEGATION OF USE FEE]
`
`REQUEST TO DIVIDE FEE
`
`TOTAL AMOUNT
`
`PAYMENT METHOD
`
`FILING INFORMATION
`
`SUBMIT DATE
`
`TEAS STAMP
`
`/thomas c. saitta/
`
`Thomas C. Saitta
`
`Attorney of record, Florida bar member
`
`06/02/2010
`
`/thomas c. saitta/
`
`Thomas C. Saitta
`
`Attorney of record, Florida bar member
`
`06/02/2010
`
`YES
`
`2
`
`200
`
`100
`
`300
`
`DA
`
`Wed Jun 02 13:48:29 EDT 2010
`
`USPTO/SOU-XXX.X.XX.XXX-20
`100602134829733669-777318
`91-460f1dc93de237913bff4f
`890bcc6412e5f-DA-65-20100
`
`

`

`602132604911789
`
`602132604911789
`
`

`

`PTO Form 1553 (Rev 9/2005)
`
`OMB No. 0651-0054 (Exp. 09/30/2011)
`
`To the Commissioner for Trademarks:
`
`MARK:(cid:160)SALT LIFE
`SERIAL NUMBER:(cid:160)77731891
`
`Trademark/Service Mark Request to Divide
`
`REQUEST TO DIVIDE
`The applicant is requesting to divide the application and specifies the following:
`The following good(s) or service(s) is/are now in use: Class 014; Class 043
`The following good(s) or service(s) remain(s) under the Section 1(b), intent to use basis: Class 003; Class 016; Class 018; Class 021; Class 026;
`Class 028; Class 032; class 041
`
`A fee payment in the amount of $200 will be submitted with the form, representing payment for the allegation of use for 2 classes.
`
`A fee payment in the amount of $100 will be submitted with the form, representing payment for the request to divide fee.
`
`

`

`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, or, if the form is being filed under 15 U.S.C. Section 1126(d) or (e), he/she believes applicant to
`be entitled to use such mark in commerce; to the best of his/her knowledge and belief no other person, firm, corporation, or association has the
`right to use the mark in commerce, either in the identical form thereof or in such near resemblance thereto as to be likely, when used on or in
`connection with the goods/services of such other person, to cause confusion, or to cause mistake, or to deceive; 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: /thomas c. saitta/(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)Date Signed: 06/02/2010
`Signatory's Name: Thomas C. Saitta
`Signatory's Position: Attorney of record, Florida bar member
`Request to Divide Signature:
`Signature: /thomas c. saitta/(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)Date Signed: 06/02/2010
`Signatory's Name: Thomas C. Saitta
`Signatory's Position: Attorney of record, Florida bar member
`
`The signatory has confirmed that he/she is an attorney who is a member in good standing of the bar of the highest court of a U.S. state, which
`includes the District of Columbia, Puerto Rico, and other federal territories and possessions; and he/she is currently the applicant's attorney or an
`associate thereof; and to the best of his/her knowledge, if prior to his/her appointment another U.S. attorney or a Canadian attorney/agent not
`currently associated with his/her company/firm previously represented the applicant in this matter: (1) the applicant has filed or is concurrently
`filing a signed revocation of or substitute power of attorney with the USPTO; (2) the USPTO has granted the request of the prior representative to
`withdraw; (3) the applicant has filed a power of attorney appointing him/her in this matter; or (4) the applicant's appointed U.S. attorney or
`Canadian attorney/agent has filed a power of attorney appointing him/her as an associate attorney in this matter.
`
`Serial Number: 77731891
`Internet Transmission Date: Wed Jun 02 13:48:29 EDT 2010
`TEAS Stamp: USPTO/SOU-XXX.X.XX.XXX-20100602134829733
`669-77731891-460f1dc93de237913bff4f890bc
`c6412e5f-DA-65-20100602132604911789
`
`

`

`FEE RECORD SHEET
`
`Serial Number:
`
`77731891
`
`RAM Sale Number: 65
`
`Total Fees:
`
`$300
`
`RAM Accounting Date: 20100603
`
`Transaction
`
`Transaction
`Date
`
`Fee per
`Class
`
`Number
`of Classes
`
`Statement of Use (SOU)
`Request to Divide (per new app.)
`
`20100602
`20100602
`
`$100
`
`Transaction Date:
`
`20100602
`
`