PTO Form 2196 (Rev 9/2005)
`
`OMB No. 0651-0056 (Exp 9/30/2017)
`
`Revocation of Attorney/Domestic Representative and/or Appointment of
`Attorney/Domestic Representative
`
`Input Field
`
`SERIAL NUMBER
`
`LAW OFFICE ASSIGNED
`
`MARK SECTION
`
`MARK
`
`NEW ATTORNEY ADDRESS
`
`STATEMENT TEXT
`
`NAME
`
`FIRM NAME
`
`STREET
`
`CITY
`
`STATE
`
`COUNTRY
`
`POSTAL/ZIP CODE
`
`PHONE
`
`FAX
`
`EMAIL
`
`The table below presents the data as entered.
`
`Entered
`
`85514262
`
`LAW OFFICE 114
`
`LAMBOGIRL
`
`By submission of this request, the undersigned updates the attorney
`information of record.
`
`Luke Brean
`
`BreanLaw, LLC
`
`P.O. Box 4120, ECM #72065
`
`Portland
`
`Oregon
`
`United States
`
`97208
`
`800-451-5815
`
`800-451-5815
`
`luke@breanlaw.com
`
`ATTORNEY AUTHORIZED TO COMMUNICATE VIA
`E-MAIL
`
`YES
`
`NEW CORRESPONDENCE ADDRESS
`
`NAME
`
`STREET
`
`CITY
`
`STATE
`
`COUNTRY
`
`POSTAL/ZIP CODE
`
`PHONE
`
`EMAIL
`
`HOSKINS, KIMBERLY A
`
`8502 E CHAPMAN AVE # 206
`
`ORANGE
`
`California
`
`United States
`
`92869-2461
`
`714-742-2223
`
`gotmaxx@yahoo.com;luke@breanlaw.com
`
`AUTHORIZED TO COMMUNICATE VIA E-MAIL
`
`SIGNATURE SECTION
`
`SIGNATURE
`
`YES
`
`/LB/
`
`
`
`SIGNATORY NAME
`
`SIGNATORY DATE
`
`SIGNATORY POSITION
`
`Luke Brean
`
`01/29/2013
`
`Attorney of record, Oregon Bar Member
`
`SIGNATORY PHONE NUMBER
`
`800-451-5815
`
`FILING INFORMATION SECTION
`
`SUBMIT DATE
`
`TEAS STAMP
`
`Tue Jan 29 20:57:43 EST 2013
`
`USPTO/RAA-XX.XX.XX.XX-201
`30129205743922421-8551426
`2-49028cb18f85842cea8ca49
`d6f83a787e62-N/A-N/A-2013
`0129205643978998
`
`
`
`PTO Form 2196 (Rev 9/2005)
`
`OMB No. 0651-0056 (Exp 9/30/2017)
`
`Revocation of Attorney/Domestic Representative and/or Appointment of
`Attorney/Domestic Representative
`
`To the Commissioner for Trademarks:
`MARK:(cid:160)LAMBOGIRL
`SERIAL NUMBER:(cid:160)85514262
`
`Original Correspondence Address :
`HOSKINS, KIMBERLY A
`ORANGE California 92869-2461
`US
`714-742-2223
`gotmaxx@yahoo.com
`
`By submission of this request, the undersigned updates the attorney information of record.
`
`Newly Appointed Attorney:
`Luke Brean
`BreanLaw, LLC
`P.O. Box 4120, ECM #72065
`Portland, Oregon 97208
`United States
`800-451-5815
`800-451-5815
`luke@breanlaw.com
`
`The following is to be used as the correspondence address:
`HOSKINS, KIMBERLY A
`8502 E CHAPMAN AVE # 206
`ORANGE, California 92869-2461
`United States
`
`714-742-2223
`gotmaxx@yahoo.com;luke@breanlaw.com
`
`Signature: /LB/(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)Date: 01/29/2013
`Signatory's Name: Luke Brean
`Signatory's Position: Attorney of record, Oregon Bar Member
`Signatory's Phone Number: 800-451-5815
`
`Serial Number: 85514262
`Internet Transmission Date: Tue Jan 29 20:57:43 EST 2013
`TEAS Stamp: USPTO/RAA-XX.XX.XX.XX-201301292057439224
`21-85514262-49028cb18f85842cea8ca49d6f83
`a787e62-N/A-N/A-20130129205643978998
`
`
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