Statement Of Change Of Trademark Information Changing The Address For Service Of Process By Appointing A Registered Agent


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 Address for Service of Process by Appointing a Registered Agent
filed pursuant to § 7-90-305.5 and § 7-90-701, et seq. 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
2. The document number of the filed document that is changed is ____________________________________.
3. The address for service of process is changed through the appointment of a registered agent.
4. The registered agent name and registered agent address of the registered agent are
(if an individual)
____________________ ______________ ______________ _____
(if an entity)
(Caution: Do not provide both an individual and an entity name.)
Street address
(Street number and name)
(Zip Code)
Mailing address
(leave blank if same as street address)
(Street number and name or Post Office Box information)
(Zip Code)
The person appointed as registered agent has consented to being so appointed.
(If applicable, adopt the following statement by marking the box and include an attachment.)
This document contains additional information as provided by law.
(Caution: Leave blank if the document does not have a delayed effective date. Stating a delayed effective date has significant
legal consequences. Read instructions before entering a date.)
(If the following statement applies, adopt the statement by entering a date and, if applicable, time using the required format.)
The delayed effective date and, if applicable, time of this document are ___________________________.
(mm/dd/yyyy hour:minute am/pm)
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Rev. 1/01/2008


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