Form For Assignment Of Registered Mark - 1999 printable pdf download

Form For Assignment Of Registered Mark - 1999

OFFICE OF THE SECRETARY OF THE STATE

30 TRINITY

STREET P.O. BOX 150470

HARTFORD, CT 06 115-0470

ASSIGNMENT

OF REGISTERED

MARK

Rev. 1211999

1. Current Name of Record Owner:

2. State of Formation of the Owner ifother than a natural person.

3. Connecticut Registration Number:

The above named owner of the mark (the Assignor), hereby assigns to the Assignee and new owner named below, all rights, title and

interest to and in mark. tonether with the good will of the business svmbolized bv the mark. along with the registration thereof.

4. Name of Assignee:

5. Address of Assignee:

6. State of Formation of the Assignee ifother than a naturalperson:

EXECUTION:

We, the assignor and the assignee, hereby declare under the penalties of false statement that the

statements made in the foregoing assignment are true.

Date

Name of Signatory for Assignor

Title of Signatory ifapplicable

10.

Signature

11.

Date

12.

13.

Name of Signatory for Assignee

Title of Signatory ifapplicable

14.

Signature

15. The ass&nor must submit three specimens or photographs of the mark as actually used in this state.

Form For Assignment Of Registered Mark - 1999