Form Tmc 58-05 - Trademark Or Service Mark Cancellation/termination
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1Contact Information
KANSAS SECRETARY OF STATE
TMC
Kansas Secretary of State
Trademark or Service Mark Cancellation/Termination
Memorial Hall, 1st Floor
58-05
120 S.W. 10th Avenue
All information must be completed or this document will not be accepted for filing.
Topeka, KS 66612-1594
(785) 296-4564
kssos@sos.ks.gov
Do not write in this space
1. Trademark or Service mark:
2. Classification:
3. Current Owner:
4. Address:
City
Street address
State
Zip
5. Expiration Date:
Month
Day
Year
I cancel/terminate said trademark or service mark for the following reason:
Signature of current owner
Date
Phone number
Instruction
Submit this application with the $15 filing fee.
Notice: There is a $25 service fee for all checks returned by your financial institution.
K.S.A.81-210
Rev. 12/28/10 jdr
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