PTO Form 1478 (Rev 9/2006)
`
`OMB No. 0651-0009 (Exp 12/31/2011)
`
`Trademark/Service Mark Application, Principal Register
`
`Serial Number: 85036165
`Filing Date: 05/12/2010
`
`The table below presents the data as entered.
`
`Input Field
`
`SERIAL
`NUMBER
`
`85036165
`
`MARK INFORMATION
`
`*MARK
`
`INTARCIA
`
`Entered
`
`STANDARD
`CHARACTERS
`
`USPTO-
`GENERATED
`IMAGE
`
`LITERAL
`ELEMENT
`
`MARK
`STATEMENT
`
`YES
`
`YES
`
`INTARCIA
`
`The mark consists of standard characters, without claim to any particular font,
`style, size, or color.
`
`REGISTER
`
`Principal
`
`APPLICANT INFORMATION
`
`*OWNER OF
`MARK
`
`*STREET
`
`*CITY
`
`*STATE
`(Required for U.S.
`applicants)
`
`Intarcia Therapeutics, Inc.
`
`24650 Industrial Blvd.
`
`Hayward
`
`California
`
`*COUNTRY
`
`United States
`
`*ZIP/POSTAL
`CODE
`(Required for U.S.
`applicants only)
`
`94545
`
`LEGAL ENTITY INFORMATION
`
`TYPE
`
`corporation
`
`

`
`STATE/COUNTRY
`OF
`INCORPORATION
`
`Delaware
`
`GOODS AND/OR SERVICES AND BASIS INFORMATION
`
`INTERNATIONAL
`CLASS
`
`005(cid:160)
`
`drug delivery system consisting of an osmotic mini-pump sold with
`medication used in the continuous release of therapeutic agents for the
`treatment of diabetes; drug delivery system consisting of an osmotic mini-
`pump sold with medication used in the continuous release of therapeutic
`agents for the treatment of metabolic disorders
`
`*I
`
`DENTIFICATION
`
`FILING BASIS
`
`SECTION 1(a)
`
`(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)FIRST USE
`ANYWHERE DATE At least as early as 02/09/2009
`
`(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)FIRST USE IN
`COMMERCE
`DATE
`
`(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)SPECIMEN
`(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)FILE NAME(S)
`
`(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)SPECIMEN
`DESCRIPTION
`
`At least as early as 02/09/2009
`
`\\TICRS\EXPORT10\IMAGEOUT 10\850\361\85036165\xml1\
`APP0003.JPG
`
`image of a label attached to the goods
`
`ADDITIONAL STATEMENTS SECTION
`
`PRIOR
`REGISTRATION(S)
`
`The applicant claims ownership of U.S. Registration Number(s) 3330632 and
`3775501.
`
`ATTORNEY INFORMATION
`
`NAME
`
`Stephanie K. Wade
`
`ATTORNEY
`DOCKET NUMBER I0004.0033
`
`FIRM NAME
`
`Dickstein Shapiro LLP
`
`STREET
`
`CITY
`
`STATE
`
`1825 Eye St., NW
`
`Washington
`
`District of Columbia
`
`COUNTRY
`
`United States
`
`ZIP/POSTAL
`CODE
`
`20006
`
`PHONE
`
`FAX
`
`202-420-3126
`
`202-420-2201
`
`CORRESPONDENCE INFORMATION
`
`

`
`NAME
`
`Stephanie K. Wade
`
`FIRM NAME
`
`Dickstein Shapiro LLP
`
`STREET
`
`CITY
`
`STATE
`
`1825 Eye St., NW
`
`Washington
`
`District of Columbia
`
`COUNTRY
`
`United States
`
`ZIP/POSTAL
`CODE
`
`20006
`
`PHONE
`
`FAX
`
`202-420-3126
`
`202-420-2201
`
`FEE INFORMATION
`
`NUMBER OF
`CLASSES
`
`FEE PER CLASS
`
`1
`
`325
`
`*TOTAL FEE DUE 325
`
`*TOTAL FEE PAID 325
`
`SIGNATURE INFORMATION
`
`(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)ORIGINAL
`PDF FILE
`
`(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)CONVERTED
`PDF FILE(S)
`(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(1 page)
`
`SIGNATORY'S
`NAME
`
`SIGNATORY'S
`POSITION
`
`hw_38100256-111522928_._INTARCIA_app_signature_page.pdf
`
`\\TICRS\EXPORT10\IMAGEOUT10\850\361\85036165\xml1\APP0004.JPG
`
`Barbara G. McClung
`
`Vice President, General Counsel and Corporate Secretary
`
`

`
`PTO Form 1478 (Rev 9/2006)
`
`OMB No. 0651-0009 (Exp 12/31/2011)
`
`Trademark/Service Mark Application, Principal Register
`
`Serial Number: 85036165
`Filing Date: 05/12/2010
`To the Commissioner for Trademarks:
`
`MARK:(cid:160)INTARCIA(cid:160)(Standard Characters, see mark)
`The literal element of the mark consists of INTARCIA.
`The mark consists of standard characters, without claim to any particular font, style, size, or color.
`
`The applicant, Intarcia Therapeutics, Inc., a corporation of Delaware, having an address of
`(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)24650 Industrial Blvd.
`(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)Hayward, California 94545
`(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)United States
`requests registration of the trademark/service mark identified above 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, for the following:
`
`(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160) International Class 005: (cid:160)drug delivery system consisting of an osmotic mini-pump sold with
`medication used in the continuous release of therapeutic agents for the treatment of diabetes; drug delivery
`system consisting of an osmotic mini-pump sold with medication used in the continuous release of
`therapeutic agents for the treatment of metabolic disorders
`
`In International Class 005, the mark was first used at least as early as 02/09/2009, and first used in
`commerce at least as early as 02/09/2009, and is now in use in such commerce. The applicant is
`submitting one specimen(s) showing the mark as used in commerce on or in connection with any item in
`the class of listed goods and/or services, consisting of a(n) image of a label attached to the goods.
`Specimen File1
`
`The applicant claims ownership of U.S. Registration Number(s) 3330632 and 3775501.
`
`The applicant's current Attorney Information:
`Stephanie K. Wade of Dickstein Shapiro LLP
`(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)1825 Eye St., NW
`(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)Washington, District of Columbia 20006
`(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)United States
`The attorney docket/reference number is I0004.0033.
`
`The applicant's current Correspondence Information:
`(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)Stephanie K. Wade
`(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)Dickstein Shapiro LLP
`(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)1825 Eye St., NW
`
`

`
`(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)Washington, District of Columbia 20006
`(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)202-420-3126(phone)
`(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)202-420-2201(fax)
`
`A fee payment in the amount of $325 has been submitted with the application, representing payment for 1
`class(es).
`
`Declaration
`
`Original PDF file:
`hw_38100256-111522928_._INTARCIA_app_signature_page.pdf
`Converted PDF file(s) (1 page)
`Signature File1
`Signatory's Name: Barbara G. McClung
`Signatory's Position: Vice President, General Counsel and Corporate Secretary
`
`RAM Sale Number: 8131
`RAM Accounting Date: 05/12/2010
`
`Serial Number: 85036165
`Internet Transmission Date: Wed May 12 11:17:37 EDT 2010
`TEAS Stamp: USPTO/BAS-XX.XXX.XX.X-201005121117373784
`00-85036165-46097c014187e98b9c948ab0de84
`a7eb14-CC-8131-20100512111522928344
`
`

`
`INTARCIA
`
`

`
`

`
`Trademark/Service Mark Application, Principal Register
`
`Declaration
`
`The undersigned, being hereby wanted 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, and the like, may
`jeopardize the validity of the application or any resulting registration, declares that he/she is properly authorized
`to execute this application 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 application is being filed under 15 U.S.C. Section I051
`(b), 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, finn, 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 S
`
`Signature:
`ame: BarbaraG.
`Signatory's
`Signatory's osition:ViceP sident,
`
`Date Signed:
`
`e
`
`ral Counsel and Corporate Secretary
`
`NOTE TO APPLICANT: When filed as part of the electronic form (i.e., scanned and attached as an image file),
`the signature page must include both the signature information and the boilerplate declaration language. Do not
`include the entire application, but do ensure that the boilerplate declaration language actually appears; a signature
`by ilselfwill not be acceptable. If, due to browser limitations, the boilerplate declaration language appears on a
`previous page when printed, you must "merge" the declaration and signature block onto a single page prior to
`signing, so that the one complete page can be scanned to create an acceptable image file, It is recommended that
`you copy-and—paste the entire text form into another document, manipulate the spacing there to move the
`declaration and signature section to a separate page, and then print this new version of the text form to send to the
`signatory.
`
`http://teas.uspto.gov/forms/xslt.service?xsl=hsign&stamp=USPTO/BAS-38.100.25.6-2010... 5/ 1 1/201 0