FORM TM-A

The Trade Marks Act, 1999

Application for Registration of a Trade Mark

1. NATURE OF THE APPLICATION STANDARED TRADEMARK

2. WHETHER APPLICATION FILED AS MICRO ENTERPRISE
IN CASE STATR UP/SMALL ENTERPRISE- PROVIDE REQUISITE CERTI
FEE: 4,500/-
3. APPLICANT
NAME Rahul Kumar Meena
TRADING AS Rahul Kumar Meena
ADDRESS (SHOULD BE PRINCIPAL PLACE OF BUSINESS OF Rajesh lal Meena, 46 c, mayur nagar, gali No 11,
APPLICANT IN INDIA)
Indore, Madhya Pradesh, India - 452001
ADDRESS FOR SERVICE Shah IP, (Attorney Code:20544)
Office No. 603, Block-A, Shilp Aaron, Opp. ARMIEDA,
Sindhubhavan Road, Bodakdev, Ahmedabad - 380 054.
Gujarat , India
MOBILE NO. 09601678737
E-MAIL ADDRESS shah@shahip.com
NATURE OF THE APPLICANT Individual
4. APPLICANT’S ATTORNEY Shah IP, (Attorney Code:20544)
Office No. 603, Block-A, Shilp Aaron, Opp. ARMIEDA,
Sindhubhavan Road, Bodakdev, Ahmedabad - 380 054.
Gujarat , India.
09601678737
shah@shahip.com
NATURE OF THE AGENT ADVOCATE (G/1711-A/2000)
REGISTRATION NO. ATTORNEY CODE-20544
5. TRADE MARK

CATEGORY OF THE MARK Device Mark

DESCRIPTION OF THE MARK Dopamine
6. IF A MARK IN A LANGUAGE OTHER THAN
NA
HINDI/ENGLISH
LANGUAGE ENGLISH
TRANSLITERATION OF THE MARK IN ROMAN
NA
SCRIPT
TRANSLATION OF THE MARK IN ENGLISH NA
7. CONDITIONS/LIMITATION TO USE THE MARK, IF
NA
ANY
8. CLASS OF GOODS / SERVICE CLASS-43
Services for providing food and drink.
9. STATEMENT AS TO USE OF MARK Proposed to be Used
10. PRIORITY CLAIM, IF ANY NA
PRIORITY CLAIMED SINCE NA
PRIORITY APPLICATION NO. NA
11. ANY OTHER IMPORTANT INFORMATION OR NA
STATEMENT
12. VERIFICATION I HEREBY INFORMED VERYFY THAT THE ABOVE MENTIONED FACTS ARE TRUE AND
CORRECTTO BEST OF MY KNOWLEDGE.
13. DETAILS OF THE PERSON SUBMITTING THE
APPLICATION

SIGNATURE:

________________________________
Rahul Kumar Meena
NAME:
AUTHORITY:
Rahul Kumar Meena