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Combined Sections 71 & 15 Intake (Madrid Protocol)

5-Year Declaration of Continued Use & Claim of Incontestability for Madrid Protocol Registrations (15 U.S.C. §§ 1141k & 1065).

1. Madrid Registration Details

Madrid Protocol Filing: Applies to U.S. registrations resulting from Section 66(a) extensions after 5 consecutive years of continuous use in U.S. commerce.

U.S. Registration Number *

WIPO International Reg. Number (IRN)

U.S. Registration Date *

Literal Mark Text *

2. Holder / Owner Information

Current Holder Name *

Check this box if current holder name differs from TSDR record (recorded assignment, merger, or legal name change).

Upload Chain-of-Title / Assignment Proof (PDF/JPG) *

Country of Domicile / Organization *

Holder Email *

Mailing Address *

City *

State / Postal Code *

3. Attorney Information (Optional for U.S. Owners)

Attorney Name

Law Firm Name

Bar Jurisdiction / State

Bar Membership Number

Attorney Email

4. Goods / Services & Specimen Uploads

Number of Classes Covered *

5. Section 15 Statutory Incontestability Affirmations

5 Years Continuous Use: The mark has been in continuous use in U.S. commerce for 5 consecutive years after U.S. registration date and is currently in use on identified goods/services.

No Adverse Decisions: There has been no final decision adverse to holder's claim of ownership or right to keep the mark on the U.S. register.

No Pending Proceedings: There is no proceeding involving said rights pending and not finally disposed of in either the USPTO or a court.

6. Electronic Signature

Signatory Relationship / Capacity *

Signatory Name *

Official Title *

Electronic Signature *