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
Changing the Registered Agent Information
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 trademark registrant, and the trademark as stated in the
statement of trademark registration are
Trademark ID number
__________________________
(Colorado Secretary of State ID number)
True name
______________________________________________________
Trademark
______________________________________________________.
2. The document number of the filed document that is changed is ____________________________________.
3.
(If applicable, adopt the following statement by marking the box and enter all changes.)
The registered agent name has changed.
Such name, as changed, is
Name
(if an individual)
____________________ ______________ ______________ _____
(Last)
(First)
(Middle)
(Suffix)
OR
(if an entity)
______________________________________________________
(Caution: Do not provide both an individual and an entity name.)
The person appointed as registered agent has consented to being so appointed.
4.
(If applicable, adopt the following statement by marking the box and enter all changes.)
The street address of such registered agent has changed.
Such street address, as changed, is
Street address
______________________________________________________
(Street number and name)
______________________________________________________
__________________________
CO
____________________.
(City)
(State)
(Zip Code)
5.
(If applicable, adopt the following statement by marking the box. Enter all changes OR mark the box to remove the mailing address.)
The mailing address of such registered agent has changed.
Such mailing address, as changed, is
Mailing address
______________________________________________________
(Street number and name or Post Office Box information)
______________________________________________________
TDMK_CHANGE_RA
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Rev. 1/01/2008