French Baker Inc Dau

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Document No.

Intellectual Property Office of the Philippines


IPOPHL-SOP-BOT-01-F02
Bureau of Trademarks Rev. No. 04

DECLARATION OF ACTUAL USE Issued by: Date:


(Prescribed Form) BOT 10/01/2017

Please check one: [ / ] Within three (3) years from filing/international registration/subsequent designation
[ ] Within one (1) year from the fifth (5 th) anniversary of the registration
[ ] Within one (1) year from date of renewal
[ ] Within one (1) year from the fifth (5 th) anniversary of each renewal
[ ] Registered under Republic Act No. 166
[ ] Tenth (10th) anniversary
[ ] Fifteenth (15th) anniversary

I, CIARALIE GARCIA____, of legal age, _____FILIPINO_______ citizen, residing at


(name of declarant)
12 THE FRENCH BAKER INC, NO.12 2ND ST, CAPITOLYO PASIG CITY depose and state under oath that:

1. I am the [ ] applicant for registration


[ / ] authorized officer of applicant-corporation
[ ] registrant
[ ] authorized officer of registered owner-corporation [ ] agent/authorized representative of applicant/registrant
of the mark THE FRENCH BAKER INC_________________________________________________________

2. The mark was accorded


[ ] Application No. _42021529093______ Filing Date 2021-12-08_______________
[ ] Registration No.__________________ Registration Date ___________________
Renewal Date _____________________
[ ] International Reg. No._____________ International Reg. Date ______________
Subsequent Des. Date_______________
[ ] International Reg. No. ____________ Date of Grant ______________________
Renewal Date______________________

for the following class/es of goods and/or services: (Attach additional sheet/s, if necessary):

30

Preparations for making bakery products; Bakery goods

35

Restaurant management for others; On-line ordering services in the field of restaurant take-out and delivery; Business

management of restaurants; Business management assistance in the establishment and operation of restaurants

39

Delivery of food by restaurants

43

Fast-food restaurant services; Fast food restaurants; Grill restaurants; Carvery restaurant services

3. The Mark is being used in the Philippines for the following class/es of goods and/or services (Attach additional
sheet/s, if necessary): __ CLASS 30,35,39,43 _______________________________________________
______________________________________________________________________________________

4. The goods are sold and/or services are rendered in the following outlet/s:
Name of Outlet Address
__SM MALLS ____NORTH EDSA, SM FAIRVIEW, SM PASIG.________________ ______________
______________________________________________________________________________________

5. As proof of actual use, attached are labels or pictures of the Mark (or pictures of the stamped container
visibly or legibly showing the Mark) or other evidence of use.

6. This affidavit is executed to attest to the truth of the foregoing and for the purpose of complying with the
requirements of R.A. 8293 and the Trademark Regulations, as amended.

CIARALIE GARCIA
Affiant

SUBSCRIBED AND SWORN TO before me this _____________ day of __________________________,


___________________________________________________________________________________.

NOTARY PUBLIC
Doc. No. _____:
Page No. _____:
Book No. _____:
Series of _____:

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