Assignment Of A Trademark Or Service Mark Form

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State of South Carolina
Assignment of a Trademark or Service Mark
Assignment fee: $3.00 per mark
1. Name of original Applicant: _________________________________________________________________________
2. Name of the new Applicant: ________________________________________________________________________
3. New Applicant’s principal place of business address: ____________________________________________________
________________________________________________________________________________________________
4. New Applicant’s place of business address in SC, if any: _________________________________________________
________________________________________________________________________________________________
5. The new Applicant is:
(Entity type must match that noted in answer to question #1; for example, applicant John Smith would be “an individual or sole proprietor…”; ABC
Company, Inc. would be “a corporation duly organized under the laws of the State of SC (or other state)”.
[ ] an individual or sole proprietor
[ ] a corporation OR [ ] limited liability company duly organized under the laws of the State of _______________
[ ] a partnership duly organized under the laws of the State of ____________________________
Names of General Partners: ___________________________________________________________________
[ ] other __________________________________________________________________________________________
6. Describe the mark, including any literal and/or design elements if claimed
(the mark as you describe it must be present on the
): ________________________________________________________________________________
specimens submitted
_______________________________________________________________________________________________
_______________________________________________________________________________________________
7. Has the applicant, or any predecessor in interest, ever filed an application to register this mark or portions of this mark
or a composite of this mark with the United States Patent and Trademark Office?
[ ] YES
[ ] NO
OR
If you answered "YES", please provide the full particulars including the filing date, serial number and status of the
application. If an application was finally refused registration or has otherwise not resulted in registration, please state the
reason for this: ___________________________________________________________________________________
_______________________________________________________________________________________________
8. Please enclose three (3) original, identical specimens showing the mark as actually used in promoting the product,
good, or service (for example, 3 identical brochures, OR 3 identical business cards, OR 3 identical photos of a T-shirt).
The specimens must reflect the mark as described in answer to question #6 of this application.
The following specimens are acceptable for a service mark:
■ 3 actual business cards or pieces of letterhead showing the mark in connection with the service; OR
■ 3 identical photos of a sign; OR
■ 3 original brochures about the service (including menus); OR
■ 3 actual advertisements for the service (including advertisements from newspapers or magazines); OR
■ 3 color print-outs of the mark used on the applicant’s Website; OR
■ 3 identical photographs that show the mark as used in advertising the service (example: a photograph of a billboard).

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