PTO Form 1553 (Rev 9/2005)
`
`OMB No. 0651-0054 (Exp. 10/31/2017)
`
`Trademark/Service Mark Request to Divide
`
`Input Field
`
`SERIAL NUMBER
`
`LAW OFFICE ASSIGNED
`
`EXTENSION OF USE
`
`MARK SECTION
`
`MARK
`
`REQUEST TO DIVIDE
`
`GOOD(S)/SERVICE(S) IN USE
`
`The table below presents the data as entered.
`
`Entered
`
`85182209
`
`LAW OFFICE 113
`
`YES
`
`SALT LIFE
`
`YES
`
`Beach umbrellas; Dog collars; Dog leashes; Duffel bags; Umbrellas;
`Luggage tags
`
`GOOD(S)/SERVICES INTENT TO USE
`
`Luggage
`
`SECTION 1(a) GOOD(S)/SERVICE(S)
`
`SECTION 1(a) GOOD(S)/SERVICE(S) ADDITIONAL
`INFORMATION
`
`The applicant requests that the good(s)/service(s) based on use in commerce
`move to registration at this time.
`
`SIGNATURE SECTION
`
`SIGNATORY FILE NAME(S)
`
`SIGNATORY'S NAME
`
`SIGNATORY'S POSITION
`
`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
`
`\\TICRS\EXPORT16\IMAGEOUT 16\851\822\85182209\xml5\
`RTD0002.JPG
`
`Keith T. Combs
`
`Managing Director
`
`/Katharine F. Rowe/
`
`Katharine F. Rowe
`
`Attorney of Record, Florida Bar Member
`
`03/11/2013
`
`YES
`
`1
`
`100
`
`100
`
`200
`
`CC
`
`Tue Mar 12 17:04:28 EDT 2013
`
`USPTO/SOU-XXX.XX.XXX.XX-2
`0130312170428793670-85182
`209-500d65e62e412e3c62f57
`
`

`
`TEAS STAMP
`
`f67a7d09723f245fcc7cdbd52
`a79ec8d33d50666868-CC-587
`8-20130312165919674537
`
`

`
`PTO Form 1553 (Rev 9/2005)
`
`OMB No. 0651-0054 (Exp. 10/31/2017)
`
`To the Commissioner for Trademarks:
`
`MARK:(cid:160)SALT LIFE
`SERIAL NUMBER:(cid:160)85182209
`
`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: Beach umbrellas; Dog collars; Dog leashes; Duffel bags; Umbrellas; Luggage tags
`The following good(s) or service(s) remain(s) under the Section 1(b), intent to use basis: Luggage
`The applicant requests that the good(s)/service(s) based on use in commerce move to registration at this time.
`Section 1(a) Good(s)/Service(s) Additional Information:
`
`A fee payment in the amount of $100 will be submitted with the form, representing payment for the allegation of use for 1 class.
`
`A fee payment in the amount of $100 will be submitted with the form, representing payment for the request to divide fee.
`
`Declaration
`
`The attached signature image file:
`
`Signatory File
`
`Signatory's Name: Keith T. Combs
`Signatory's Position: Managing Director
`
`Request to Divide Signature:
`
`Signature: /Katharine F. Rowe/(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)Date Signed: 03/11/2013
`Signatory's Name: Katharine F. Rowe
`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: 85182209
`Internet Transmission Date: Tue Mar 12 17:04:28 EDT 2013
`TEAS Stamp: USPTO/SOU-XXX.XX.XXX.XX-2013031217042879
`3670-85182209-500d65e62e412e3c62f57f67a7
`d09723f245fcc7cdbd52a79ec8d33d50666868-C
`C-5878-20130312165919674537
`
`

`
`

`
`Declaration
`
`Applicant requests registration of the above-identified trademark/service mark in the United States Patent and
`Trademark Oflice on the Principal Register established by the Act of July 5, 1946 [15 U.S.C. Section 105! ct
`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 gocdsfservices identified above, as evidenced by the attached specimen
`(3) 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 hefshe is properly authorized to execute this
`form on behalf of the applicant; hefshe beiieves the applicant to be the owner ofthe trademarkfservice mark
`sought to be registered;
`d that all statements made ofhis/her own knowledge are true; and that all statements
`made on information a - lief are believed to be true.
`
`Signature Seetlo :
`
`_
`Signature:
`Signatory‘s Name: Keith . Combs
`Signatory‘s Position; Managing Director
`
`Datesigced: 3-t’L.i 3-
`Signatery‘s Phone: 904-24 l—7258
`
`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 irseffwiif not be acceptable. it‘, 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~pas£c 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 ofthe text form
`to send to the signatory.
`
`http:/ftcas.uspto.gcv/sou/xslt.service'?xsi=hsign
`
`

`
`FEE RECORD SHEET
`
`Serial Number:
`
`85182209
`
`RAM Sale Number: 85182209
`
`Total Fees:
`
`$200
`
`RAM Accounting Date: 20130313
`
`Transaction
`
`Transaction
`Date
`
`Fee per
`Class
`
`Number
`of Classes
`
`Statement of Use (SOU)
`Request to Divide (per new app.)
`
`20130312
`20130312
`
`$100
`
`Transaction Date:
`
`20130312