TO ORDER A TRADEMARK SEARCH OR APPLICATION

If you would like a mark searched or an application prepared, Jay S. Horowitz, P.C. offers three ways to order our services: by mail, fax, or on-line. If you have any questions, please call Jay S. Horowitz, P.C. toll free at 1-800-304-8266.

Order by Mail (Payment by check). Please complete, print, and send the following Trademark Questionnaire along with checks for the fees described in the PRICING section above. Fees should be made payable to "Jay S. Horowitz, P.C." and filing fees should be made payable to "Commissioner of Patents and Trademarks." Please send these materials to the following address:

Jay S. Horowitz, P.C., Attorney at Law, M.B.A.
7401 Westlake Terrace, Suite 602, Bethesda, MD 20817

Order by Fax (Payment by check or credit card). Please complete, print, and fax the following Trademark Questionnaire to 1-301-330-3966 (operational 24 hours a day). Please note that we cannot begin a search until we have received payment because we have to pay the on-line search charges in advance.

Order On-Line (Payment by check or credit card). Please complete the following Trademark Questionnaire then click the "Order On-Line - SEND" icon. Note: Jay S. Horowitz, P.C. does not suggest that you send credit card information over the Internet. However, we will accept your credit card information if you are willing to take this risk. Otherwise, you can Order On-Line and mail us a check. Please note that we cannot begin a search until we have received payment because we have to pay the on-line search charges in advance.


Name of Owner of Mark
(Person or Entity):
Address:
City:
State:
Zip:
Phone:
Fax:
E-mail:
Description of mark sought to be registered:
Description of goods and/or services with which mark is or will be used:
State the type of search desired:



ADDITIONAL INFORMATION NEEDED TO PREPARE A TRADEMARK APPLICATION

If owner of mark is an individual, state citizenship:
If owner of mark is an entity, state the type of organization (Corporation, Limited Liability Company, Partnership, Sole Proprietorship) :
If owner is a corporation, in what state is it incorporated?
List the name and title of the officer who will sign the application:
Has the mark been used (anywhere)?Yes No
If yes, state the date in which the mark was first used (anywhere):On or before (month,day,yr.)
Has the mark been used in connection with the sale of a product or service in interstate commerce? Yes No
If yes, state the date in which the mark was first used in interstate commerce:On or before (month,day,yr.)
If the mark has been used, please describe in what manner it has been used (i.e. on labels or tags affixed to goods, on packaging material, on advertising or promotional materials, etc.):
If you have not yet used the mark, please describe how you intend to use the mark (i.e. on labels or tags affixed to goods, on packaging material, on advertising or promotional materials, etc.):

* Please provide at least five specimens illustrating how your mark is used with your products and / or services. Suitable specimens for marks used with products are labels or tags which are affixed to the goods, packaging material, or photographs of how the mark appears on the goods themselves. Suitable specimens for marks used with services are advertising or promotional materials used for marketing the services.



PAYMENT INFORMATION

Search fees are $150 for a federal search and $150 for a multi-state search (results within 5 business days). The fee for a combined federal and multi-state search is $250 per mark (separately the fee would be $300). Expedited service (results within 2 business days) is available for an additional 20% of the base charge. Our fee to prepare a trademark application is $350 per application and the government filing fee is $335.
 Number   Amount
Federal Searches ($150 per search)$
Multi-State Searches ($150 per search)$
Combined Federal/Multi-State ($250 per search)$
Application Preparation ($350 each)$
Expedited Fee (add 20% of base charge) $
TOTAL FEE $

How would you like to pay?    CheckCredit Card
If paying by check, please make fees to us payable to Jay S. Horowitz, P.C. The filing fee should be made payable to Commissioner of Patents & Trademarks.

Credit Card Number:
Expiration Date:
Name that appears on card:
Type of Credit Card:


NOTE: Jay S. Horowitz, P.C. does not suggest that you send credit card information over the Internet. However, we will accept your credit card information if you are willing to take this risk. Otherwise, you can Order On-Line and mail us a check or fax this form to 1-301-330-3966.

© COPYRIGHT JAY S. HOROWITZ, P.C., 1991, 2003.