Statement Of Transfer Of Trademark Registration Transferring A Trademark To An Individual Resident Of Colorado

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Form must be filed electronically.
Paper forms are not accepted.
This copy is a sample and cannot be submitted for filing.
Statement of Transfer of Trademark Registration
Transferring a Trademark to an Individual Resident of Colorado
filed pursuant to § 7-70-106 of the Colorado Revised Statutes (C.R.S.)
1. The entity ID number, if applicable, and the true name of the trademark registrant transferring the
trademark are
Entity ID number
__________________________
(if applicable)
(Colorado Secretary of State ID number)
True name
______________________________________________________.
2. The trademark ID number and the trademark as stated in the statement of trademark registration are
Trademark ID number
__________________________
(Colorado Secretary of State ID number)
Trademark
______________________________________________________.
3. The true name of the transferee is
______________________ ________________ ______________ _______.
(Last)
(First)
(Middle)
(Suffix)
4. The principal address of such transferee and, if different, the mailing address of such transferee are
Principal (street) address
______________________________________________________
(Street number and name)
______________________________________________________
__________________________ ____ ____________________
(City)
(State)
(Zip/Postal Code)
_______________________ ______________
(Province – if applicable)
(Country)
Mailing address
______________________________________________________
(leave blank if same as street address)
(Street number and name or Post Office Box information)
______________________________________________________
__________________________ ____ ____________________
(City)
(State)
(Zip/Postal Code)
_______________________ ______________.
(Province – if applicable)
(Country)
5.
(Mark the applicable box. Caution: Mark only one box.)
Such registrant has transferred to such transferee the rights to the trademark, including all associated
goodwill, to which such statement of trademark registration pertains.
OR
Such transferee has by operation of law succeeded to the rights to the trademark, including all
associated goodwill, to which such statement of trademark registration pertains.
6.
(If applicable, adopt the following statement by marking the box and include an attachment.)
TDMK_TRF_IND
Page 1 of 2
Rev. 1/01/2008

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