Mark Registration Form - Nevada Secretary Of State
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BARBARA K. CEGAVSKE
Secretary of State
555 East Washington Ave., #5200
Las Vegas, Nevada 89101
(702) 486-2880
Website:
Mark Registration Form
(PURSUANT TO NRS 600)
Page 1
Important: Read attached instructions before completing form.
USE BLACK INK ONLY - DO NOT HIGHLIGHT
ABOVE SPACE IS FOR OFFICE USE ONLY
1. Please Designate
One Mark Per
TRADEMARK
TRADE NAME
SERVICE MARK
Application:
2. Mark to be
Registered:
(name of mark or words to
be included in the mark)
Does the mark include a design?
3. Design:
NO
YES
(If yes, attach drawing or facsimile)
4. Classification
Number:
(see instructions; one
class per application)
(If entity)
5. Applicant:
INDIVIDUAL
ENTITY
STATE OF INCORPORATION:
(please designate)
6. Name of Applicant:
(from question five)
7. Business Address:
Street Number/Post Office Box
City
State
Zip Code
Date the mark was first used by applicant in Nevada (display as mm/dd/yyyy):
(See NRS 600.320)
8. Original Mark Date
In Nevada:
Nevada Secretary of State Mark Registration Pg1
This form must be accompanied by appropriate fees.
Revised: 1-5-15
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