Basic Data for Trademark Registration

Name

(Individual / Proprietorship / Partnership Firm / Private Limited / Public Limited / LLP / Trust / Section 25 Company)

Communication Address

Contact No. (Primary)

Contact No. (Alternate)

Description Date of

Email ID. (Primary)

Email ID. (Alternate)

Full Name of Signatory

(Person who represents Proprietorship /Partnership Firm / Private Limited / Public Limited / LLP/ Trust / Section 25 Company )

Name of Partners / Directors

( If Partnership Firm / Private Limited / Public Limited / LLP/Trust / Section 25 Company )

Nationality of the Signatory

Residence Address of Signatory

Brand Name

Manufacturer / Trader / Service Provider

Trade Description (Goods / Services)

(Please mention in depth of your brand name usage or industry to use )

User Date (DD/MM/YYYY)

(Please mention from when you are using this Brand Name/Proposed to use.)