Form Tmsm - 03 - Application To Assign A Registered Trade Or Service Mark
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2TMSM – 03
Rev. 10/02
New Jersey Division of Revenue
APPLICATION TO ASSIGN A REGISTERED TRADE OR SERVICE MARK
This form may be used by applicants seeking to reassign a registered State trade or service mark pursuant to
NJSA 56. Applicants are responsible for strict adherence to all requirements as set forth in State law.
1. Trade/Service Mark Number:
(as assigned by the State Treasurer and listed on the Certificate of Registration)
2. Owner Information:
a. Name:
(must match the name indicated on the Division of Revenue's records):
b. Current Business Address:
(must match the address indicated on the Division of Revenue's records)
4. Assignee Information:
a. Name:
b. Address:
5.Signatures:
The mark is hereby assigned.
_______________________________________
_______________
(Signature of Owner, or a Member of the Firm, or an
(Date)
Officer of the Corporation or Business Applying)
_______________________________________
_______________
(Assignee)
(Date)
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Parent category: Financial