Madrid System Form Trademarkers - Upated

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MADRID SYSTEM TRADEMARK APPLICATION FORM

Date: DD/MM/YY
Contact Email:

1. TRADEMARK INFORMATION

Trademark: Country of Origin:


Application No.: Registration No.:
(if applicable) (if applicable)
Priority Trademark Priority TM Filing
No: (if applicable) Date: (if applicable)

Trademark type: Wordmark & Logo (B&W) Logo (B&W) Wordmark


Wordmark & Logo (Color) Logo (Color)
Preferred Language of
English French Spanish
correspondence

Designated Countries:

Afghanistan Ghana Poland


African Intellectual Property Greece Portugal
Organization (OAPI)
Albania Hungary Republic of Korea
Algeria Iceland Republic of Moldova
Antigua and Barbuda India Romania
Armenia Indonesia Russian Federation
Iran (Islamic
Australia Republic of) Rwanda
Austria Ireland San Marino
Azerbaijan Israel Sao Tome and Principe
Bahrain Italy Serbia14
Belarus Japan Sierra Leone
Belgium Kazakhstan Singapore
Bhutan Kenya Slovakia
Bosnia and Herzegovina Kyrgyzstan Slovenia
Botswana Lao People’s Spain
Democratic
Republic
Brunei Darussalam Latvia Sudan
Bulgaria Lesotho Sweden
Cambodia Liberia Switzerland
China Liechtenstein Syrian Arab Republic
Colombia Lithuania Tajikistan

Email this form to your Account Manager or to admin@trademarkers.com


MADRID SYSTEM TRADEMARK APPLICATION FORM
Croatia Luxembourg Thailand
Cuba Madagascar The former Yugoslav Republic
of Macedonia
Cyprus Malawi Tunisia
Czech Republic Mexico Turkey
Democratic People's Republic of Monaco Turkmenistan
Korea
Denmark Mongolia Ukraine
Egypt Montenegro United Kingdom
Estonia Morocco United States of America
Eswatini Mozambique Uzbekistan
European Union Namibia Viet Nam
Finland Netherlands Zambia
France New Zealand Zimbabwe
Gambia Norway
Georgia Oman
Germany Philippines

Please indicate in which class/es you wish to register your trademark and provide the corresponding
description of goods or services:

Class(es): Goods/Services:

2. TRADEMARK OWNER
Full legal name:
Country of
Company Name:
Incorporation:
Address: Telephone:
City: Province/State:
Postal code: Country:

3. CONTACT INFORMATION
Same as owner
Contact name:
Address: Telephone:
City: Province/State:
Postal code: Country:

4. BILLING INFORMATION

Email this form to your Account Manager or to admin@trademarkers.com


MADRID SYSTEM TRADEMARK APPLICATION FORM
Same as contact
Billing name:
Address:
City: Province/State:
Postal code: Country:

5. PAYMENT ALTERNATIVES

A. CREDIT CARD PAYMENT


Credit card type: Visa MasterCard
Amex Discover
Name as it appears on your card:
Credit card number:
Last 3 digits on back of
Card Expiration: MM/YY Security code: card. Amex last 4 digits
on front of card.
Address:
City: Province/State:
Postal code: Country:
C. WIRE TRANSFER PAYMENT
In US Dollars
Bank: Chase Bank
Bank address: 401 Madison Ave., New York NY 10017
Routing number/ABA: 267084131
Swift code: CHASUS33
Beneficiary: Trademarkers LLC
Beneficiary account number: 559640730
Beneficiary address: 246 West Broadway, New York, NY 10013 USA
Reason for payment: Indicate your invoice number and/or your Trademarkers.com user email.

Email this form to your Account Manager or to admin@trademarkers.com


MADRID SYSTEM TRADEMARK APPLICATION FORM
Note: In case the money transfer comes from a country other than USA, please add USD 30 to cover
bank processing fees.

D. CHECK PAYMENT
Bank Branch Deposit: Check by post mail:

Bank: Chase Bank Make check in USD, payable in a US Bank to


Beneficiary: Trademarkers LLC Trademarkers LLC and write on the back “For
Account number: 559640730 deposit only Trademarkers LLC # <Acct No>”. To
process the service more promptly, send it by
Branch deposit must be made in person only at courier.
USA Citibank N.A. branches. Checks sent by Please mail check to:
post to Citibank N.A. will not be accepted. Trademarkers LLC
246 West Broadway
New York, NY 10013
USA

Email this form to your Account Manager or to admin@trademarkers.com

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