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Trademark Order Form

Step 1:

Personal & Business Information

First Name
Last Name
Middle Initial
Daytime Phone (9am - 5pm)
Evening phone (after 5pm)
Fax Number
Company Name
(if incorporated, include state of incorporation)
Address Line 2
City, State, ZIP
Your Relation to Company
E-Mail

The Top Three Choices of a Mark or Phrase you Wish to trademark.
70 Characters or less please.

First Choice
Second Choice
Third Choice
Please indicate what your mark will represent, services it will provide, what the main function of your company is Goods & Services Class
Type of Entity applying for the Mark
Number of trademarks You are Requesting
Federal Mark Only ("Y" Yes , "N" No)

Location of Business **REQUIRED**

Address Line 1
Address Line 2
City, State, ZIP
County

Trademark Services Requested

Basic Federal Search Yes ($99.95. )
Comprehensive Search(Federal & State) Yes ($200.00)
Advanced Search (Federal,State, & Common Law) Yes ($225.00)
Logo Design Search (add) Yes ($55.00 + $25.00 Applicaion Fee)
Logo Design Service Contact Me Regarding Logo Design
Hard Copy Report & Application (Choose if you are unable to Open Adobe Files)
Yes ($200.00)
Class of Goods or Services
Leave Blank ($ )
Expedited Service 2 day $200.00

Business Software

QuickBooks Yes ($160.00 + $6.00 s&h per order)
QuickBooks Pro Yes ($225.00 + $6.00 s&h per order)
Peachtree Accounting Yes ($129.00 + $6.00 s&h per order)
BizPlan Yes ($149.99 + $6.00 s&h per order)
Yes ($149.00 + $6.00 s&h per order)
INC USA D is
Future Reference II Yes ($100.00 + $6.00 s&h per order)

Step 3:

Payment Method

Sub Total $
Application Fees $
Total Authorized to Charge $
Card Type
Card Number
Name On Card
Expiration Date /
Billing Address Line 1
Billing ZIP Code