1.

NATURE OF THE APPLICATION:

(a) The applicant must choose either of the following categories-

1. Standard trademark, 2.Collective tradeMark, 3. Certification tradeMark, 4.Series tradeMarks

Standard trademark here means an application for registration of a trademark not being a Collective or Certification trademark or Series of trademarks

(b) In case of Collective Mark or Certification Mark the draft regulations with form TM-M must be submitted.

2.

Whether application filed as (Please choose and specify)

In the case of startup/Small Enterprise, the requisite certificate should be provided.

(Individual/startup/Small Enterprise/others)

FEE:

(See First Schedule for Appropriate Fee)

3.

APPLICANT

Name:*

Trading as:

Address:*

(State)                               (Country)

[This address should be the address of the applicant’s principal place of business in India]

Address for service:

(State)                               (Country)

(a) Unless otherwise specifically stated, the applicant’s address shall be the address for service of the applicant who has a principal place of business in India.

(b) The address for service in India must be provided, in case the applicant does not carry business in India.

Mobile No.:

E-mail address*:

Nature of the applicant:

[The applicant must choose either of the following categories-

1.Individual, 2. Partnership Firm, 3. Body-incorporate including Private Limited/Limited Company, 4. Limited Liability Partnership, 5.Society, 6.Trust, 7. Government Department, 8.Statutory Organization, 9. Association of persons, 10. Hindu Undivided Family]

4.

APPLICANT’S AGENT(if any):

Name*:

Address*:

[In case of authorization of agent, the address of the agent may be mentioned as the applicant’s address for service]

Mobile No.*:

E-mail address:*

Nature of the Agent:

[The applicant must choose either of the following categories-

Registered Trade Marks Agent, 2. Advocates, 3. Constituted Attorney]

Registration No.:

5.

TRADEMARK:

(trademark to be mentioned here)

Category of mark:

[The application must choose either of the following categories-

1. Word Mark (if includes one or more words, letters, numerals or anything written in standard character), 2. Device mark (it includes any label, sticker, monogram, logo or any geometrical figure other than word mark), 3. Colour (when the distinctiveness is claimed in the combination of colours with or without the device), 4. Three-dimensional trademark (it includes shape or packaging of goods), 5. Sound]

Description of the mark:

[(a) Description of the trademark must be provided in terms of Rule 26

(b) In the case of trademarks submitted in the specific combination of colours other than black and white, it shall be presumed that the distinctiveness of the mark is claimed in that combination of colours and application will be considered accordingly.

(c) In case of colour marks the description may be like “The Trademark consists of three vertical stripes in the colour PURPLE, GREEN and YELLOW applied to the fascias of buildings and to doors as shown in the representation of the mark.”

(d) In case of sound marks representation of specific musical notes must be submitted at the place provided for the trademark. The applicant is also required to submit sound clipping in MP3.]

6.

IF MARK IN A LANGUAGE OTHER THAN HINDI OR ENGLISH:

Language:

Transliteration of the mark in Roman script:

[Transliteration of the mark in the Roman script must be provided in case the mark is in a language other than Hindi or English]

Translation of the mark in English

[Transliteration of the mark in English must be provided in case the mark is in a language other than Hindi or English]

7.

Conditions or Limitations to use the trademark, if any

8.

CLASS OF GOODS OR SERVICE:

DESCRIPTION OF GOODS AND SERVICE:

9.

STATEMENT AS TO USE OF MARK:

[  ] Proposed to be used.

[ ] The mark is used by the applicant or its predecessor in title

Since …………………… in respect of all the goods and/or services mentioned in the application.

[(a) The applicant must select either of the above.

(b) The date of use must be given in the format (DD/MM/YYYY) and shall refer to all items mentioned in the application.

(c) In case the use of the Trade Mark is claimed prior to the date of application, the applicant shall file an affidavit testifying to such use along with supporting documents

(d) The statement as to use of the mark once made shall be final]

10.

PRIORITY CLAIM, IF ANY:

Priority claimed since

DD/MM/YYYY

Priority claim based on application filled in the Convention Country or organization

Name of the country or organization

Priority Application No.

[The priority must be claimed in respect of all goods and services mentioned in the application]

11.

ANY OTHER IMPORTANT INFORMATION OR STATEMENT:

[Applicant may provide here any other information or statement in relation to his application]

12.

VERIFICATION

I hereby verify that the above-mentioned facts are true and correct to the best of my knowledge and belief.

13.

DETAIL OF THE PERSON SUBMITTING THE APPLICATION:

Signature:

Name:

Authority: