American Indian Trademark Application
Personal Information
Company name:
Contact person first name:
Contact person last name:
Tribal affiliation:
Mailing address:
Company phone:
Email address:
Website address:
Fax number:
Total number of employees employed by your organization:
What specific product(s) will carry the trademark?
What category(ies) do your product(s) fall under (select all that apply)?
Fresh and Dried Meats (buffalo, beef, chicken, pork)
Syrup, Sugar, Jams, Jellies, or Preserves
Seafood or Fresh Water Fish (wild, fresh, frozen, smoked, canned)
Herbs (loose leaf tea or medicinal)
Produce (wild, fresh, dried or packaged, fruits or vegetables)
Beverages (coffee, wine, kombucha)
Wild Rice
Non-Edible (herbal salves, lip balms, candles, lotions, body wash, shampoo, conditioner, soaps, detergents, dish liquid, etc.)
Grains, Dry Foods, or Mixes
Nuts, Seeds and Legumes
Condiments & Oils (vinaigrettes, cocktail sauces, or mustards)
Other
Specify other product(s):
What type of operation do you have (choose all that apply)?
Small Business
Manufacturing
Entrepreneur
Wholesale
Farmers Market
Retail
Farm or Ranch Operation
Other
Cooperative
Specify other operation type:
How do you plan to make use of the trademark?
Incorporate trademark onto packaging
Attach sticker to existing package
Combination of imprinted containers and stickers
Other
Specify other trademark use:
What certifications do you currently include on your packaging?
Made/Produced by American Indian Trademark
USDA Organic
FDA Certified
Certified GF (Gluten Free)
Kosher
Non-GMO
Certified B Corporation
USDA Inspected and Approved
Halal Certified
Other
Specify other certification(s):
What type of events are you interested in attending?
Domestic Events/Trade Shows
International Trade Shows
Supporting Documents
Please provide and attach documentation (through the file upload below) that verifies the user is a federally recognized Tribal member/entity or an Alaskan Village as defined by law; or at least a controlling share interest.
Verification the user is a federally recognized Tribal member/entity or Alaskan Village as defined by law
OR a controlling shareholder with 51% interest or more
For Tribal Enterprises/Entities: Proof of tribal ownership - Tribal Council Resolutions OR Authorized Statement from the current Tribal Executive Leader
For Individual Indian Producers: Proof of tribal enrollment - Tribal identification OR enrollment card
A controlling shareholder with 51% interest or more: Applies to individuals, tribes, tribal organizations, firms, partnerships, corporations, or associations applying
Verification user is a federally recognized Tribal member/entity or Alaskan Village as defined by law:
Photo 1:
Photo 2:
Photo 3:
Please upload a complete inventory list with individual product descriptions for every product:
T
he information collected is solely for the purpose of IAC and will not be shared with any third party.
Signature:
Date:
Contact Information