TRADEMARK REQUIRED FOR FILING INFORMATION AND DOCUMENTS

1. One (1) Clear Specimen of the trademark

2. A list of good/services for which protection is sought (according to Nice International Classification)

3. Full name and street adress of the applicant
(and State of Incorporation if applicant is not an individual)

4. Priority date and country of filing (if applicable)

5. Power of Attonery. (Attached) Signed only, no legalization is necessary.