1LAW OFFICES OF LLOYD J.

JASSIN
The Paramount Bldg.
Floor 12
1501 Broadway
New York, NY 10036
(212) 354-4442 (tel.)
jassin@copylaw.com
___

www.copylaw.org

TRADEMARK QUESTIONNAIRE

Thank you for taking the time to fill out this questionnaire.  Your 
answers will allow us to work more efficiently and economically on 
your behalf. 

PROPOSED TRADEMARK*: 

_______________________________________________________________
*If available, please attach a copy of the proposed mark, including all associated
elements. If a design mark or logo, please attach a JPEG or PDF of the mark.

1. Legal name of the person who will sign the Trademark Application:

(a)   If signing on a behalf of a corporation or other entity, 
please provide correct legal name and state of registration or 
incorporation. 

(b) If signing as an individual, what is your citizenship?

2. Your address or your principle place of business:

3. How do we contact you?  
 Telephone: ___________________

Text: ________________________

E­Mail:    ___________________

4. Nature of your business: 

5. Who will own the trademark? (check one)

___ an individual.    

___ a partnership.

___ a corporation.

___ a limited liability company.

___ other (please explain)

6. (a)  Has the mark been used in the US to advertise or promote the
sale of goods or services?  ___ Yes ___ No*.  

*If your answer is “No,” please provide details of the anticipated timeline for
use of the mark.

(b) What was the first date you offered the goods or services for
sale, or put them on public display?

(c)  What goods and/or services are intended to be offered in 
connection with this trademark?  

(d)  Please list domain names and social media user names you’ve 
obtained that use the trademark, or something similar to your proposed
trademark:   
__________________
__________________
__________________
__________________
__________________
__________________

7. Please provide the date of first commercial shipment across state
lines of the goods or service bearing the trademark. Please state
whether you have evidence of this date, and what that evidence is. If
the mark is associated with different goods or services, please
provide dates relevant to type of use with each separate or specific
good or service.

8.  If you answered yes to question 7, please provide examples

(specimens) of how the trademark is or will be used in connection with
products, goods, or services. Acceptable specimens include labels, 
tags, promotional materials, brochures or packaging materials used in 
connection with the goods or services.1  

9. Will the mark appear in logo or design form?  If available, 
please email us a high quality black and white JPEG or PDF.  

10. Will any other marks, slogans, designs or distinctive packaging 
be used with the mark?  If so, please describe in detail.

11. Have you ever conducted a professional trademark search to 
determine the availability of the mark?  If yes, please attach a copy 
of the trademark search report.  Was the search evaluated by an 
attorney?

12.  Do you plan to assign your trademark registration to any entity 
or individual?  If so, please explain.