Application for Registration of a Proposed Trademark

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To: The Registrar of Trade-marks, Gatineau, Canada.

The applicant _____________________________________ whose full post office address of its principal office or place of business is

__________________________________________________________________________

__________________________________________________________________________

applies for the registration, in accordance with the provisions of the Trade-marks Act, of the trademark identified below.

The trademark is the word(s) (or is shown in the attached drawing)

__________________________________________________________________________

The applicant, by himself/herself or through a licensee, or by himself/herself and through a licensee, intends to use the trademark in Canada in association with _____________________________________ and requests registration of the trademark in respect of such goods.

The applicant, by himself/herself or through a licensee, or by himself/herself and through a licensee, intends to use the trademark in Canada in association with _____________________________________ and requests registration of the trademark in respect of such services.

The applicant is satisfied that he or she is entitled to use the trademark in Canada in association with the _____________________________________ described above.

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