In addition to the requirements for a trademark or service mark application (see TMEP §§801-806.01(e)), a concurrent use application must include a verified statement in which the applicant attests to certain information. See 37 C.F.R. §2.42(b).

The required verified statement must include the following:

1. (1) the applicant’s goods and/or services, the geographic area in which the applicant is using the mark in commerce, and the mode of use for which the applicant seeks registration;
2. (2) the concurrent users’ names and addresses, the concurrent user’s goods and/or services, and the registrations issued to or applications filed by the concurrent users (if any), to the extent known by the applicant; and
3. (3) the geographic areas in which the concurrent user is using the mark in commerce, the mode of use by the concurrent users, and the time periods of such use by the concurrent users, to the extent known by the applicant.

See 15 U.S.C. §§1051(a)(3)(D), 1053; 37 C.F.R. §2.42(b); TBMP §1101.

For a §1(a) application, an applicant must also modify the verified statement required for an unrestricted application under 37 C.F.R. §2.33(b)(1) (see TMEP §804.02) to indicate an exception, i.e., that no other person except as specified in the application has the right to use the mark in commerce. 37 C.F.R. §2.33(f); see 15 U.S.C. §1051(a)(3)(D).

The applicant does not have to insert the information in the list above directly in the verification or declaration at the end of the application; this information may be set forth anywhere in the application as long as it is attested to by the applicant.

In addition to the requirements noted above, concurrent use applications must meet other conditions, depending on whether the application is subject to a concurrent use proceeding before the Board (see TMEP §§1207.04(e)-(e)(i)), pursuant to the decree of a court (see TMEP §§1207.04(f)-(f)(i)), or based on a final decision by the Board in a prior concurrent use proceeding (see TMEP §§1207.04(g)-(g)(i)).