Form must be filed electronically.
Paper forms are not accepted.
This copy is a sample and cannot be submitted for filing.
Statement of Change of Trademark Information
Regarding Resignation or Other Termination of Registered Agent
filed pursuant to § 7-90-305.5 and § 7-90-702 of the Colorado Revised Statutes (C.R.S.)
1. The trademark ID number, the true name of the registrant, and the trademark as stated in the statement of
trademark registration are
Trademark ID number
(Colorado Secretary of State ID number)
2. The document number of the filed document that is changed is ____________________________________.
3. The registered agent has resigned or is otherwise no longer the registered agent.
4. The name and address of such registered agent are
(if an individual)
____________________ ______________ ______________ _____
(if an entity)
(Caution: Do not provide both an individual and an entity name.)
(Street number and name)
(leave blank if same as street address)
(Street number and name or Post Office Box information)
(If applicable, adopt the following statement by marking the box.)
The mailing address in the records of the Secretary of State is no longer different than the street
address and is no longer required.
5. The date on which such registered agent resigned or otherwise ceased to be the registered agent is
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