TRADEMARK QUESTIONNAIRE

S.No. Details Required Please write the details

1. Trademark Owner Name Nadeem Khan
(Write the name of Company or
Firm or Individual, in whose
name the trademark to be
registered)
2. Type of Organisation/Owner Individual
(Write whether Pvt. Ltd./Public
Ltd./LLP/ Partnership
Firm/Proprietorship
Firm/Trust/Individual)

3. Address of the Trademark B2 Villa, Saldhana Orchid, Siolim, Goa- 403519,

Owner

4. Full name of all the

Partners/Directors
/Trustees
(Not required in case of
Individual or Proprietorship
applicants)
5. Full name of the person who Nadeem Khan
will sign Authorization
Letter
(i.e. on behalf of
company/LLP/firm/trust)
6. Residence address, Age, B2 Villa, Saldhana Orchid, Siolim, Goa- 403519
Nationality,Mobile No. & Age 37
Email Id of the Signatory Indian
8975477093
nadeem@mentorsway
7. Brand Name for Trademark Mentorsway
8. LOGO of the Trademark
 Trademark can be applied
even without a LOGO. If not
available leave it blank.
 You can also send the
LOGO separately in an
email attachment

9. Logo/Image The lines defines the real estate just like our
Explanation:Explain in 2- 3 business and it's going upward which defines
lines the image or style or the name Mentorsway.
figure or design of logo
(Required if the brand name
consists a logo)

Eg: “The trademark

consist of the alphabet ‘S’ with
sharp ends pointing towards
upward direction applied over the
background of circle”

10. Trade descriptionof

Goods/Services
(Please write exact goods or Real Estate Consultant
services sold / promoted under
this brand name, in 3-4 lines.
Include only specific goods or
services name)
Eg: Software
 Development:Software
development and IT enabled
services.
11. Whether Small Business or
Large Enterprise
(Not applicable to Individual
Applicants)

Large Enterprise means

 If the investment in
Plant & Machinery is
more than Rs. 50 crore
And
 Turn over is more than
Rs.250 crore
12. Write whether the applicant No
is Selling/Trading products
on any online portal
(like Amazon / Flipkart /
Snapdeal, etc.)
13. User Date of the Proposed to be used
Brand/Mark
Please select any one option:
a) Proposed to be used/to
be used in future
b) Already in use (If already
in use write the date since
when brand is in
use)Please refer to the
below Important Note
regarding user affidavit.

14. GSTIN Number of the

Applicant  30BETPK4494N1ZT
(This is needed to prepare the
TAX Receipt after completion
of the work OR mention NA (if
not applicable or you don't have
a GST number)
Important Note:

A) In case if the brand name is already in use, it is mandatory to give a notarized “User Affidavit” on stamp
paper of Rs.100 by the applicant (format for the same shall be provided by Startupwala).

B) If you are selling products on Amazon, they only accept “Wordmark”. If your brand name contains logo,
you may need to apply two trademark applications one with the logo (Device mark) and another
application without logo (Wordmark).

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