[Name of submitting party] hereby certifies that the information submitted to the
Clearinghouse is, to the best of [Name of submitting party] knowledge, complete and
accurate, that the trademarks set forth in this submission are currently in use in the manner
set forth in the accompanying specimen, in connection with the class of goods or services
specified when this submission was made to the Clearinghouse; that this information is
not being presented for any improper purpose; and that if, at any time, the information
contained in this submission is no longer accurate, the [Name of submitting party] will
notify the Clearinghouse within a reasonable time of that information which is no longer
accurate, and to the extent necessary, provide that additional information necessary for the
submission to be accurate. Furthermore, if any Clearinghouse-verified mark subsequently
becomes abandoned by the Trademark Holder, the Trademark Holder will notify the
Clearinghouse within a reasonable time that the mark has been abandoned, or has been the
subject of successful opposition, invalidation, cancellation, or rectification proceedings