(J) POWER OF ATTORNEY 
An applicant desiring to appoint an attorney may add the following 
paragraph to Form A, B, or C: 
“The undersigned hereby appoints —— —, whose postal 
address is ——— Street, city of ———, State of ———, his (its) 
attorney, to prosecute this application for registration, with full 
powers of substitution and revocation, and to make alterations and 
amendments therein, to receive the certificate, and to transact all 
business in the Patent Office connected therewith.” 
(K) SEPARATE POWER OF ATTORNEY 
To the Commissioner of Patents: 
The undersigned hereby appoints —— - ———— of —— State 
of ———, his attorney to prosecute this application for registration, 
with full power of substitution and revocation, to make alterations 
and amendments therein, to receive the certificate and to transact 
all business in the Patent Office connected therewith. 
(Signed) 
(IL) DECLARATION FOR AN INDIVIDUAL 
State of Pennsylvania, ld 
County of Philadelphia.|™ 
William Johnson, being duly sworn, deposes and says that he is 
(Name of applicant) 
the applicant named in the foregoing statement; that he believes 
the foregoing statement is true; that he believes himself to be the 
owner of the trade-mark sought to be registered; that no other 
person, firm, corporation, or association, to the best of his knowl- 
edge and belief, has the right to use said trade-mark in the United 
States, either in the identical form or in any such near resemblance 
thereto as might be calculated to deceive; that said trade-mark is 
used by him in commerce among the several States of the United 
States (and between the United States and foreign nations or Indian 
tribes)!; that the description and drawing presented truly represent 
the trade-mark sought to be registered; and that the specimens show 
(Or facsimiles) 
the trade-mark as actually used upon the goods. 
WirLiam JoHNsoN. 
(Full signature of applicant) 
Subscribed and sworn to before me, a notary public, this 15th day 
(Official title) (Date of 
of June, 1906. 
execution) 
[SEAL.] RicaArD Jongs, 
Notary Public. 
(Official title) 
+ Ifapplicant does not have commerce with foreign nations or Indian tribes, this clause should be omitted. 
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