Form F0024 - Trade And Service Mark Assignment Form 1996 Page 2
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2F0024 - Page 2 of 2
OFFICE OF THE MISSISSIPPI SECRETARY OF STATE
P.O. BOX 136, JACKSON, MS 39205-0136
(601) 359-1333
*0024-2-
Trade and Service Mark Assignment
By:
Signature of
(
Please keep writing within blocks)
Assignor
Printed Name
Title
By:
Signature of
(
Please keep writing within blocks)
Assignee
Printed Name
Title
ACKNOWLEDGMENT
State of
County of
Sworn to and subscribed before me this
day of
,
Notary
Notary
Seal
Signature
My commission expires
INSTRUCTIONS: The above assignment must be signed by both the Assignor and the Assignee. If either is a corporation or
other entity, the name of the corporation or entity is to be inserted as Assignor or Assignee with the signature of the proper
authorities. Please enclose Filing Fee of $50.00 made payable to the Mississippi Secretary of State.
page 2 of 2
[F0024] Rev. 11/96
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