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Assignment Of Mark Registration Form

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ASSIGNMENT OF MARK REGISTRATION

1. The mark to be assigned is:

Registration Number:

2. ASSIGNOR:

Name:

If Assignor is a corporation, the state in which incorporated & FL registration Number:

Address:

City:

State/Zip:

3. ASSIGNEE:

Name:

If Assignee is a corporation, the state in which incorporated & FL registration number:

Address: ____________________________________________________________________________

City:

State/Zip___________________________________

4. All right, title and interest in and to said mark, together with the good will of the business in

which the mark is used (or that part of the good will of the business connected with the use of

the mark) is hereby assigned by ____________________________________________________ to

(the Assignor)

(the Assignee)

(Assignor’s Signature)

(Assignee’s Signature)

(Typed or Printed Name of Person

Signing Above)

On this

day of

personally appeared before me,

who is personally known to me

whose identity I proved on the basis of

(Notary Seal)

Signature of Notary Public

Instructions: The assignment must be signed by both the assignee and the assignor. If a corporation, an

officer of the corporation must sign. Both the assignee’s and the assignor’s signature must be

acknowledged before a Notary Public. If you need assistance, call the Registration Section at (850) 245-

6051.

FILING FEE: $50

Division of Corporations, P. O. Box 6327 Tallahassee, FL 32314

Assignment Of Mark Registration Form

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