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                                                                                                                                    PAUL D. PATE                        Application  for  Renewal
                                                                                                                                Secretary of State                         of Registered Mark
                                                                                                                                                                        One actual specimen of use of mark or facsimile of 
                                                                                                                                                                        specimen of use of mark must accompany            this application
                                                                                                                                   State of Iowa                                                                        

      The applicant,                                                                                                                                                    , is the owner of a mark which has been registered
      with the Secretary of State under certificate number                                                                                                                          and hereby makes application for
      renewal of the registration.

      Address of Applicant:

      Street                                                                                                                                                  City                            e t a t S                        P I Z

      Indicate One:    (A) Individual                                                                                                (B) Limited liability company                (C) Corporation                    (D) Other
        If B,  ,C  or D, state where organized:
        If D, type of entity:

        If a partnership, names and addresses of current partners:

      Descriptio nof mark

      The mark described above has been and   is still   in use by the applicant                                                                                                    in   the state      of   Iowa    , as well as in 
      the state(s) of :

      I certify under penalty of perjury and pursuant to the laws of the State of Iowa that the preceding is true and correct.                                                                                          

        g i S ne : d                                                                                                                                       : e l t i T                                  D    : e t a

      NOTES:

      1. The application fee is $10.00. Make checks payable to SECRETARY OF STATE.
      2.   One actual specimen of use of mark or facsimile of specimen of use of mark must accompany this application.
      3. The information you provide will be open for public inspection under Iowa Code section 22.11.

                                                                                                                                         SECRETARY OF STATE
                                                                                                                                         Business Services Division
                                                                                                                                         Lucas Building, 1st Floor
                                                                                                                                         Des Moines, Iowa  50319

                                                                                                                                         Phone: (515) 281-5204
                                                                                                                                            FAX:  (515) 242-5953
635_0117
rev 12/21                                                                                                                                   Website: sos.iowa.gov






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