A. Subject to the limitations set forth in this article, any person who is domiciled in this state and who adopts and uses a trademark or service mark, or any person who adopts and uses a trademark or service mark in this state, may file in the office of the secretary of state, on a form to be furnished by the secretary of state, an application for registration of that mark setting forth at least the following information:

1. 1. The name and email and business address of the person applying for such registration and, if a corporation, the state of incorporation.
2. 2. The goods or services in connection with which the mark is used, the mode or manner in which the mark is used in connection with such goods or services and the class in which such goods or services fall.
3. 3. The date when the mark was first used anywhere, and the date when the mark was first used in this state by the applicant or the applicant's predecessor in business.
4. 4. A statement that the applicant is the owner of the mark and that no other person has the right to use the mark in this state either in the identical form of the mark or in such near resemblance to the mark as might be calculated to deceive or to be mistaken for the mark.
5. 5. A statement that the applicant has conducted a search and found that the trademark or service mark does not consist of or comprise a mark that so resembles a mark registered in this state or a mark or trade name previously used in this state by another and not abandoned and that, when applied to the goods or services of the applicant, the mark is not likely to cause confusion or mistake or to deceive.
6. 6. A statement whether the applicant previously sought to register the trademark or service mark with the United States patent and trademark office and, if so and the registration was denied, the reasons for the denial.

B. The application shall be:

1. 1. Signed by the applicant, or by a member of the firm or any officer of the corporation or association applying.
2. 2. Accompanied by a specimen or facsimile of the mark in a format specified by the secretary of state by rule.