Application For Assignment Of Trademark
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1APPLICATION FOR ASSIGNMENT
OF TRADEMARK/SERVICE MARK
STATE OF NEW MEXICO
This form may only be used to record the assignment of a trademark/service mark.
1.
Name of assignor:
2.
Name of assignee:
3.
Business address of assignee:
4.
If assignee is a partnership, enter the state in which partnership is organized and the full and complete
names of the general partners:_____________________________________________________________
5.
If assignee is a corporation or limited liability company, enter state of incorporation:
6.
Name, address, and phone number of contact person for assignee:
7.
File number of the trademark/service mark being assigned:
8.
Name of trademark/service mark being assigned:
9.
Date of assignment:
10. Person, mailing address and phone number if different from above:
__________________________________________________
(
)
Phone
I hereby swear or affirm under penalty of perjury that the information provided is true, correct and complete and further
that I registered in the State of New Mexico the trademark/service mark identified above, and transferred all rights and
interest in the trademark/service mark to the assignee named herein.
N
By:
Please Print Assignor’s Full Name
Assignor Signature and Title
I hereby swear or affirm under penalty of perjury that I have adopted and am now using in the State of New Mexico the
trademark/service mark identified above.
By:
Please Print Assignee’s Full Name
Assignee Signature and Title
Submit application and $25.00 recording fee to:
Office of the Secretary of State
325 Don Gaspar, Suite 301
Santa Fe, New Mexico 87503
Form TK4 (October 2003)
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