FORMULIR PERMOHONAN PENDAFTARAN MEREK INDONESIA
APPLICATION FORM OF INDONESIAN TRADEMARK REGISTRATION
Data Permohonan (Application)
Nomor Transaksi Number of Transaction Nomor Permohonan Number of Application
Merek Dagang Online Filing Asal Permohonan
Office of Origin Tipe Permohonan Type of Application Jenis Permohonan Sub Type of Application
Usaha Mikro dan Usaha Kecil Tanggal Penerimaan
Receipt Date
: :
: :
:
: 2021-11-19 10:06:36
IPT2021166336 IPT2021166336
Data Merek (Description of Mark)
Tipe Merek Type of Mark Nama Merek Name of Mark
Deskripsi Description
: :
:
Warna Colors
Terjemahan Translation
Transliterasi/Pengucapan Transliteration
: :
:
Disclaimers Disclaimers
:
Etiket Gambar/Label Merek Merek Kata dan Lukisan
MOTIVATEA + LOGO
Lingkaran, Daun
Hijau, Putih
Tidak Ada Terjemahan
Esteh, Untuk Kamu Yang Paling Berartea
Image of Mark
Data Pemohon (Applicant)
Signed by IPROLINE Merek on 2021/11/24 08:12:52
Jenis Pemohon Owner Type Kewarganegaraan Nationality
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Alamat Address
Kabupaten/Kota City
Provinsi Province
: :
:
Telepon Phone
:
NGAKAN MADE APRIADIANA
Perorangan
Indonesia
Link/Br. Sidembunut, Kel. Cempaga, Kec. Bangli, Kab. Bangli, Provinsi Bali
Kabupaten Bangli
Bali
+6285738200002 Nama
Name
:
Surel :
Kode Pos :
Zip Code Negara Country
:
80612
Indonesia
Alamat Surat Menyurat (Mailing Address) Alamat
Address
Kabupaten/Kota City
Provinsi Province
: :
:
Telp/Fax Phone
:
Surel :
Kode Pos :
Zip Code Negara Country
:
Data Kuasa (Representative/IP Consultant)
Alamat Address
:
Telp/Fax Phone
:
Surel :
Nama Konsultan Consultant Name
:
Nama Kantor :
Office Name
No Konsultan
Number of Consultant :
Data Prioritas (Priority Data)
No
Negara / Kantor Merek No Prioritas
(Priority Date) (Priority Country) (Number of Priority) Tanggal Prioritas
Data Kelas (Class)
Kelas Uraian Barang dan/atau Jasa
(Class) (Description of Goods/Services)
35 Administrasi urusan bisnis waralaba; Bantuan bisnis yang terkait dengan waralaba; Jasa advis dan
konsultasi terkait manajemen, operasi dan waralaba hotel; Jasa manajemen waralaba; Jasa waralaba, yaitu, penawaran bantuan manajemen bisnis dalam pendirian dan pengoperasian restoran yang menyajikan ayam; Memberikan informasi kerjasama waralaba (administrasi) restoran, cafe yang menyediakan minuman berbahan dasar kopi, teh dan coklat; Waralaba restoran, yaitu, penawaran bantuan manajemen bisnis dalam pendirian dan pengoperasian restoran; administrasi franchise (waralaba); administrasi
komersial untuk lisensi barang dan jasa bagi orang lain, untuk program diskon yang memungkinkan peserta mendapatkan diskon barang dan jasa melalui penggunaan kartu anggota diskon, kompetisi untuk
keperluan periklanan, program loyalitas konsumen, skema insentif dan loyalitas pelanggan, program loyalitas menyangkut diskon atau insentif, program imbalan loyalitas, skema keanggotaan, skema insentif penjualan dan promosi, program insentif promosi penjualan, urusan bisnis waralaba, urusan bisnis toko ritel; administrasi urusan bisnis waralaba; bantuan bisnis terkait dengan pendirian waralaba; bantuan dalam manajemen bisnis komersial waralaba; bantuan manajemen bisnis di bidang waralaba; bisnis dan
manajemen; bisnis dan manajemen; jasa waralaba hotel (manajemen dan operasional); jasa waralaba, yaitu penawaran assistensi manajemen bisnis dalam pendirian dan pengoperasian hotel, restoran, klub malam, bar, spa, fasilitas rekreasi dan kebugaran, toko eceran, kondominium, gedung apartemen, pusat konferensi, resor timeshare (kepemilikan bersama dengan perjanjian bagi waktu) untuk pihak lain; layanan bisnis di bidang manajemen bisnis; layanan konsultasi bisnis yang berkaitan dengan pendirian dan pengoperasian waralaba; layanan konsultasi manajemen bisnis yang berkaitan dengan waralaba; layanan konsultasi yang berkaitan dengan pengoperasian waralaba; layanan manajemen bisnis yang berkaitan dengan waralaba;
layanan periklanan bisnis yang berkaitan dengan waralaba; layanan waralaba dalam bentuk memberikan bantuan manajemen bisnis dalam pendirian dan pengoperasian hotel; layanan waralaba dalam bentuk memberikan bantuan manajemen bisnis dalam pendirian dan pengoperasian restoran; layanan waralaba dan ritel; layanan waralaba yang menyediakan bantuan bisnis; layanan waralaba, termasuk memberikan bantuan manajemen bisnis dalam pengaturan dan pendirian resort hotel, motel, dan restoran; layanan waralaba, termasuk memberikan bantuan teknis dalam pengaturan dan pendirian resort hotel, motel, dan restoran; layanan waralaba, yaitu bantuan manajemen bisnis dalam pendirian dan pengoperasian restoran;
layanan waralaba, yaitu, memberikan bantuan bisnis dalam pengoperasian, pengaturan dan pendirian resort hotel, hotel, motel, akomodasi, fasilitas akomodasi dan restoran; layanan-layanan konsultasi bisnis yang berkaitan dengan pendirian dan pengoperasian administrasi waralaba; manajemen bisnis; manajemen bisnis; manajemen bisnis untuk pengoperasian waralaba; manajemen file bisnis; manajemen model bisnis;
memberikan bantuan dalam pengelolaan bisnis waralaba; memberikan bantuan di bidang komersialisasi produk dalam kerangka kontrak waralaba; memberikan bantuan di bidang manajemen bisnis dalam kerangka kontrak waralaba; memberikan bantuan di bidang manajemen bisnis dan komersialisasi produk dalam kerangka kontrak waralaba; memberikan informasi kerjasama waralaba (administrasi) restoran, cafe yang menyediakan makanan dan minuman berbahan dasar kelor; menyediakan bantuan pemasaran terkait dengan waralaba; penyediaan bantuan bisnis untuk pengoperasian waralaba; rekrutmen dan manajemen stempel perdagangan, kupon, kartu berjenis akumulasi poin waralaba, keanggotaan; saran bisnis yang berkaitan dengan waralaba; saran bisnis yang berkaitan dengan waralaba restoran; saran dan konsultasi bisnis terkait dengan waralaba
Administration of the business affairs of franchises; Business assistance relating to franchising; business advisory and consultancy services relating to hotel management, operations, and franchising; -; Franchise services, namely, offering business management assistance in the establishment and operation of
restaurants featuring chicken; -; Restaurant franchising, namely, offering business management assistance in the establishment and operation of restaurants; -; administration (commercial -) of the licensing of the goods and services of others, of a discount program for enabling participants to obtain discounts on goods and services through use of a discount membership card, competitions for advertising purposes, consumer loyalty programs, customer loyalty and incentive schemes, loyalty programs involving discounts or
incentives, loyalty rewards programmes, membership schemes, sales and promotional incentive schemes, sales promotion incentive programs, the business affairs of franchises, the business affairs of retail stores;
administration of the business affairs of franchises; Business assistance relating to the establishment of franchises; assistance in franchised commercial business management; business management assistance in the field of franchising; business and management; business and management; hotel franchising services (management and operational); franchise services, namely, offering business management assistance in the establishment and operation of hotels, restaurants, night clubs, bars, spas, recreational and fitness facilities, retail stores, condominiums, apartment buildings, conference centers, and timeshare resorts for others; business services in the field of business management; business advisory services relating to the establishment and operation of franchises; business management advisory services relating to franchising;
advisory services relating to the operation of franchises; business management services relating to franchising; business advertising services relating to franchising; franchising services in the nature of providing business management assistance in the establishment and operation of hotel; franchising services in the nature of providing business management assistance in the establisment and operation of restaurants; franchise and retail services; Franchising services providing business assistance; Franchising services, including rendering business management assistance in the organization and establishment of resort hotels, motels and restaurants; Franchising services, including rendering technical assistance in the organization and establishment of resort hotels, motels and restaurants; franchising services, namely, business management assistance in the establishment and operation of restaurants; franchising services, namely, rending business assistance in the operation, organization and establishment of resort hotels, hotels, motels, accommodation, accommodation facilities and restaurants; business consulting services
35 related to the establishment and operation of franchise administration; business management; business management; business management for franchise operation; business file management; business management of models; providing assistance in the management of franchised businesses; providing assistance in the field of product commercialization within the framework of a franchise contract; providing assistance in the field of business management within the framework of a franchise contract; providing assistance in the field of business management and product commercialization within the framework of a franchise contract; -; providing marketing assistance relating to franchising; provision of business
assistance in the operation of franchises; recruitment and management of trading stamp, coupon, point accumulation type card franchise, member; business advice relating to franchising; business advice relating to restaurant franchising; business advice and consultancy relating to franchising
30 Bahan pengganti teh; Boba teh durian; Boba teh durian; Makanan berbahan dasar teh; Minuman Teh Susu Telur; Minuman barbahan dasar teh termasuk teh hitam -, teh hijau-, dan minuman berbahan dasar teh oolong; Minuman berbahan dasar teh dan teh herbal; Minuman jahe (teh jahe); Minuman teh krisan; Ocha / teh jepang; Sahi (Teh); Teh Ginseng; Teh Krisan; Teh Oolong; Teh Tarik; Teh bunga tisane; Teh dan teh herbal; Teh daun kelor; Teh daun sirsat; Teh herbal dan seduhan herbal; Teh herbal daun kelor; Teh hijau jepang; Teh hitam es; Teh latte; Teh lemon; Teh rosela; Teh serai; Teh serbuk daun kelor; Teh yang menggunakan kelor; Teh, termasuk teh herbal, teh buah, teh rooibos, dan teh lain yang memiliki rasa;
bubuk teh instan; campuran untuk membuat teh; campuran untuk membuat teh chai; daun teh; daun teh, yang diproses; es krim dengan menggunakan teh; es teh; kantong teh; kantong teh tanpa obat; kapsul teh, diisi; minuman berbahan dasar teh; minuman dengan bahan dasar teh; minuman es berbahan dasar teh;
minuman teh; minuman teh boba; minuman teh boba; minuman teh dengan susu; minuman yang terbuat dari teh; mugi-cha [teh barley panggang]; oyaki dengan menggunakan teh; parfait dengan menggunakan teh; polong teh, diisi; teh; teh abu-abu earl; teh acanthopanax; teh atau kakao; teh barley; teh barley yang dipanggang; teh bebas kafein; teh beraroma; teh buah; teh bubuk; teh bunga jeruk nipis; teh celup; teh chai; teh coca; teh dengan aroma bibit gandum; teh dingin; teh fieldmint; teh ginseng merah; teh goji berry; teh herbal yang menggunakan kantong teh yang mengandung kelor; teh hijau; teh hijau bubuk; teh hijau nanah mint; teh hitam; teh instan; teh jahe; teh jeruk nipis; teh kangzhuan [teh Cina fermentasi]; teh kombucha; teh kunyit; teh lengkeng; teh melati; teh melon; teh oolong [teh Cina]; teh pelangsing; teh peppermint; teh putih; teh rooibos; teh rosella; teh rosemary; teh rumput hijau; teh sage; teh sitrun; teh spearmint; teh susu; teh susu berbahan dasar teh; teh susu, teh yang mendominasi; teh yang difermentasi
tea substitutes; -; -; Tea-based food; -; Tea-based beverages including black tea-, green tea-, and oolong tea- based beverages; Tea and herbal tea-based beverages; -; Chrysanthemum tea drink; -; -; Ginseng Tea;
Crysanthenum tea; -; -; -; Tea and herbal tea; -; -; Herbal teas and herbs; -; Japanese green tea; iced black tea; tea latte; Lemon tea; -; -; -; -; tea, including herbal tea, fruit tea, rooibos tea and other flavored tea;
instant tea powder; mixes for making tea; mixes for making chai tea; tea leaf; tea leaves, processed; ice cream using tea; iced tea; tea bag; Nonmedicated tea bags; tea capsules, filled; tea-based beverages;
Beverages with tea base; tea-based iced beverages; tea beverages; bubble tea; bubble tea; tea beverages with milk; beverages made of tea; mugi-cha [roasted barley tea]; oyaki using tea; parfait using tea; tea pods, filled; tea; earl grey tea; acanthopanax tea; tea or cocoa; barley tea; roasted barley tea; theine-free tea; scented tea; fruit teas; powdered tea; lime blossom tea; -; chai tea; coca tea; tea flavored with wheat seedling; -; fieldmint tea; red ginseng tea; goji berry tea; -; green tea; powdered green tea; nanah mint green tea; black tea; instant tea; ginger tea; lime tea; kangzhuan tea [fermented Chinese tea]; kombucha tea; turmeric tea; longan tea; jasmine tea; melon tea; oolong tea [Chinese tea]; slimming tea; peppermint tea; white tea; rooibos tea; roselle tea; rosemary tea; verdant grass tea; sage tea; citron tea; spearmint tea;
milk tea; tea-based milk tea; milk tea, tea predominating; fermented tea Dokumen Lampiran (Attachment)
Identitas pemohon jika pemohon lebih dari satu pihak (Additional Applicant)
No Nama Pemohon Tambahan
1 MAXIE DJONNY,ST,MT
2 NITA SETYAWATI
Gambar Merek Tambahan (Additional Mark)
No Gambar Merek Tambahan
Tanda Tangan Pemohon / Kuasa (Applicant / Representative Signature)
(NGAKAN MADE APRIADIANA) Tempat dan Tanggal (Place and Date) : Jakarta, 19-11-2021
