OFFICE OF SECRETARY OF STATE 
                                                                     CORPORATIONS DIVISION 
                                                                     2 Martin Luther King Jr. Dr. SE 
                                                                     Suite 313 West Tower 
                                                                     Atlanta, Georgia 30334 
                                                                                   (404) 656-2817 
                                                                                   http://sos.ga.gov/ 
       Secretary of State                           
                                                             APPLICATION FOR REGISTRATION 
                                                             TRADEMARK OR SERVICE MARK 
  DO NOT WRITE IN SHADED AREA - SOS USE ONLY 
  
    INTAKE DATE: ___________    INTAKE INITIALS: ___________    AMOUNT RECEIVED: _____________         CHECK #/ M.O. #/ CC: ______________________________________ 
                                                                                                                               
                                     NOTICE TO APPLICANT: SEE GENERAL INSTRUCTIONS FOR COMPLETING THIS APPLICATION. 
   In compliance with O.C.G.A. §§10-1-440 et seq., the undersigned, having adopted and used a trademark or service mark in this State and desiring to file the 
   same for public record in the Office of the Secretary of State of Georgia, does hereby certify, under penalty of perjury, the following: 
   1. 
  
      Name of Applicant 
   2. 
  
      Principal Business Address                                                                       City                         State            Zip Code 
    
      Mailing Address (if different from principal business address)                                   City                         State            Zip Code 
   3. If applicant is an entity, please indicate the state of incorporation/formation/organization: 
  
   4. Describe the mark. The description you provide is the way the mark will be registered. (Attach additional sheet if necessary) 
       
   5. Disclaimer (if applicable): No claim is made to the exclusive right to use: 
                                                                                                                                    apart from the mark as shown. 
   6. (a) If a trademark, what goods are offered or sold under the mark? OR (b) If a service mark, what services are provided under the mark?  
  
   7. Class No:                                (A separate application must be filed for each class in which a registration of the mark is sought.) 
  
   8. Date of first use of the mark by applicant, predecessor, or licensee. (Give month, day and year.) 
                             (a) Anywhere:                                           (b) In Georgia: 
  
   9. Mode or manner in which the mark is used in connection with identified (a) goods or (b) services. Check all that apply in either (a) or (b):   
      (a) Trademark:         To tags/labels affixed to goods         To tags/labels affixed to containers of goods                  Directly to containers of goods 
                             Directly to goods                       Other: ________________________________________________________________ 
      (b) Service Mark:      Advertising brochures                   Advertising leaflets/flyers                        Newspaper advertisements 
                             Signs                                   Business cards                                     Menus 
                             Other: ________________________________________________________________________________________________  
   10.  The applicant is the owner of the mark described herein, the mark is in use, the specimens filed herewith are true and correct, and, to the best of his/her 
      knowledge, no other person except the applicant has the right to use such mark in this State either in its identical form or in such near resemblance as to 
      be likely, when applied to the goods or services of such other person, to cause confusion or mistake, or to deceive. 

      Signature of Applicant: ________________________________________________      Print Name: ___________________________________________  

      Official Title (if signing for an entity): _____________________________________ Date: ________________________________________________ 

      Email: _____________________________________________________________      Secondary Email: ______________________________________ 
    
    Mail or deliver to the Secretary of State, at the above address, the following: 
      1) This completed application. 
      2) Three (3) specimens of the mark as currently used. May be 3 samples of the same specimen. (See General Instructions) 
      3) A drawing page showing only the mark on an 8 ½ x 11 white sheet of paper. 
      4) A filing fee of $15.00 payable to the Secretary of State. Filing fees are non-refundable and non-transferable. 
    Keep a copy of your submitted application, specimens, and drawing page for your records. 
                                                                                                                                                     FORM TMAPPL 
                                                                                                                                                     (Rev. 8/2019) 

                                                                 GENERAL INSTRUCTIONS 
Fee: The filing fee is $15.00 per application. Make checks or money orders payable to the Secretary of State. Filing fees are non-refundable. 
Specimens: Three (3) specimens showing current use of the mark in commerce must be submitted with the application. Three samples of the same specimen are 
acceptable. If a trademark, the specimen should be the actual tags or labels affixed to goods, actual tags or labels affixed to containers of the goods, or packaging used 
on the goods. If a service mark, the specimen should be in the form of an advertisement (e.g. newspaper ad, leaflet, brochure, flyer, etc.) and must denote the service 
rendered to the public. If specimens are bulky or of value, (i.e. jewelry, t-shirts, caps, etc.), please submit photographs of the actual specimens. The photographs should 
clearly and legibly depict the mark along with all material pertinent to the registration. Specimens will not be returned to applicant. 
Drawing Page: A “drawing” of the mark on an 8 ½ x 11 white sheet of paper should accompany the application. A “drawing” is a clear and accurate visual drawing, 
picture, or depiction of the mark. A “drawing” is not necessarily hand-drawn. If the mark contains only words, list only those words on the drawing page. A drawing 
should not show additional words or designs that are not part of the mark. 
In Use: Prior to registration of the mark, the mark must be in use in Georgia on or in connection with the goods/services identified in the application. Goods must 
already be offered for sale or in distribution in Georgia in order to register a trademark. Services must already be sold or otherwise rendered in this State in order to 
register a service mark. The mere advertising of future goods or services does not constitute use of a trademark or service mark in Georgia. 
 
Application Form : Type or print in blue or black ink. Complete all applicable items. Items #3 and #5 may not apply to all applications. Attach additional sheet(s) if needed. 
The word “mark” refers to both trademarks and service marks. All previous versions or revisions of this application form are obsolete.  
Item 1:   Enter the name of the applicant. Applicant is the owner of the mark; the applicant is not necessarily the person filing the application. The applicant may be an 
       individual or an entity (e.g. corporation, limited liability company (LLC), limited partnership).  
Item 2:   Enter the principal business address of the applicant. If mailing address is different, enter the mailing address in the space provided. 
Item 3:  If applicant is an entity (e.g. corporation, LLC, limited partnership), indicate the state of incorporation, formation, or organization of the entity. 
Item 4:  Enter a concise description of the mark. List only one mark per application. If the mark consists of word(s) only, list only the words. If the mark is a design only, 
       then provide a detailed written description of the design. If the mark is word(s) and a design, then provide a detailed written description of the word(s) and 
       design. The description must be consistent with how the mark appears on the specimens. Do not attach a copy of the mark and write “see attached.” Do not 
       draw the mark on the application. Do not write in Item 4 of the application what the mark may mean, stand for, or represent. If the mark contains non-English 
       words, please provide an English translation. Attach additional sheets if necessary. 
Item 5:  If applicable, enter a disclaimer for word(s) or design(s) which are merely descriptive of the goods or services, geographically descriptive (e.g. “Georgia,” “USA”), 
       or designate entity status (e.g. “Inc.,” “Company,” “LLC”). A disclaimer does not remove the disclaimed matter from the mark. It is simply a statement that the 
       applicant does not claim exclusive rights in the disclaimed wording or design apart from the mark.  
Item 6:  If a trademark, state the specific goods sold or distributed with the mark affixed; or, if a service mark, state the specific services rendered. List only those 
       goods/services currently available. Do not include future goods/services. All goods/services listed in Item 6 must fall within the class designated in Item 7. 
Item 7:   Enter class number. Number must correspond with the identified goods/services. List only one class number per application. If a mark is used in more than one 
       class, it may be registered in more than one class. A separate application must be filed for registration in each eligible class. See below for list of classes. 
Item 8:   Enter the date of first use of the mark "anywhere" and the date of first use of the mark "in Georgia" (month/day/year). If the mark has only been used in 
       Georgia, the date of first use would be the same for both "anywhere" and "in Georgia." If only a year or month/year is entered, the date presumed for purposes 
       of registration will be the last day of the year or last day of the month entered. The mark must already be in use in Georgia prior to registration. 
Item 9:   Enter the mode or manner in which the mark is used in connection with the identified (a) goods or (b) services. If a trademark, how is the mark applied to the 
       goods? If a service mark, how is the mark used in rendering the services? Check all that apply in either (a) or (b). Attach additional sheet if needed. 
Item 10:  The application must be signed. If applicant is an individual, then the individual must sign. If applicant is a partnership, a general partner must sign. If applicant 
       is a corporation, an officer of the corporation must sign. If applicant is an LLC, a manager or member must sign. Persons signing on behalf of an entity must 
       designate his or her title. An attorney may sign for the applicant by including the statement "Attorney for ____________." 
Submit your application along with specimens, drawing page, and $15.00 filing fee to the Secretary of State’s office at the address listed on the application. Keep a copy 
of your submitted application, specimens, and drawing page for your records. The Secretary of State’s office will review each application and determine the availability 
of registration in Georgia. If the application is deficient, incomplete, or ineligible for registration, a notice will be sent to applicant. If an application is approved for 
registration, a certificate of registration will be issued. Registration is effective for ten years, and may be renewed for subsequent ten year terms.  
The Secretary of State’s office cannot provide legal advice. This office does not search records of federal or other state registrations and cannot guarantee availability 
of marks. Registration of a mark does not prevent another person from registering the name as a trade name in a county, or incorporating or forming a business entity 
under the same name. Registration of your mark provides public notice of your claim to the mark. If you have a legal question about registering a trademark or about 
trademarks and service marks in general, you should consult with your attorney. Questions regarding the application process may directed to (404) 656-2817.   
                                                                           CLASSES 
Each application shall list only one class of goods or services in Item 7. All goods or services offered within that class may be listed in Item 6. The classes are as follows: 
A. GOODS  
 1. Raw or partly prepared materials                        18. Medicines and pharmaceutical preparations               36. Musical instruments and supplies 
 2. Receptacles                                             19. Vehicles                                                37. Paper and stationery 
 3. Baggage, animal equipments, portfolios, and             20. Linoleum and oiled cloth                                38. Prints and publications 
   pocketbooks                                              21. Electrical apparatus, machines, and supplies            39. Clothing 
 4. Abrasives and polishing materials                       22. Games, toys, and sporting goods                         40. Fancy goods, furnishings, and notions 
 5. Adhesives                                               23. Cutlery, machinery, and tools, and parts thereof        41. Canes, parasols, and umbrellas 
 6. Chemicals and chemical compositions                     24. Laundry appliances and machines                         42. Knitted, netted, and textile fabrics and 
 7. Cordage                                                 25. Locks and safes                                          substitutes therefor 
 8. Smokers' articles, not including tobacco products       26. Measuring and scientific appliances                     43. Thread and yarn 
 9. Explosives, firearms, equipments, and projectiles       27. Horological instruments                                 44. Dental, medical, and surgical 
 10. Fertilizers                                            28. Jewelry and precious metal ware                          appliances 
 11. Inks and inking materials                              29. Brooms, brushes, and dusters                            45. Soft drinks and carbonated waters 
 12. Construction materials                                 30. Crockery, earthenware, and porcelain                    46. Foods and ingredients of foods 
 13. Hardware and plumbing and steamfitting                 31. Filters and refrigerators                               47. Wines 
      supplies                                              32. Furniture and upholstery                                48. Malt beverages and liquors 
 14. Metals and metal castings and forgings                 33. Glassware                                               49. Distilled alcoholic liquors 
 15. Oils and greases                                       34. Heating, lighting, and ventilating apparatus            50. Merchandise not otherwise classified 
 16. Paints and painters' materials                         35. Belting, hose, machinery packing, and                   51. Cosmetics and toilet preparations 
 17. Tobacco products                                            nonmetallic tires                                      52. Detergents and soaps 
  
B. SERVICES  
 1. Miscellaneous (i.e. medical or personal type services)  4. Construction and repair                                  7. Material treatment                     
 2. Advertising and business                                5. Communication                                            8. Education and entertainment  
 3. Insurance and financial                                 6. Transportation and storage                                
                                                                                                                                        TMAPPL GENERAL INSTRUCTIONS  
                                                                                                                                                                (Rev. 8/2019)