Semtech Limited Use Trademark Request Form

Permission Request Form for Limited Use of the

Semtech® Mark and/or Logo

Use this form ("Permission Request Form") to request permission to use the Semtech logo and/or Semtech mark.

Semtech may require additional information prior to making a determination. Semtech may, in its sole discretion and for any reason, refuse to allow a proposed use, require modifications to any proposed use, or require discontinuation of any proposed use.

1. Requesting Entity

Company Name*

Street Address*

City*

Country*

Website URL*

2. Proposed Use

3. Sample of Proposed Use

Sample of Proposed Use (required)*

4. Proposed Use Date

Proposed Use Date (insert date you want to begin use of logo or mark)*

Proposed Use Date (insert date you want to end use of logo or mark)*

5. Additional Details

Additional Details (please provide any additional details about your intended use)

6. Usage Agreement

LIMITED USE AGREEMENT - READ CAREFULLY

I agree to comply with the proper usage of the Semtech logo in accordance with the Semtech Corporation’s Use Guidelines.*

7. Submission and Contact Information

By completing and submitting this form, you confirm that you have the authority to act on behalf of the company identified above and that the statements contained herein are true.

First name*

Last name*

Job Title*

Email*

Phone number*