Trademark Or Service Mark Assignment
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FILE #:
State of Illinois
TM/SM-35a
Trademark or Service Mark
This space for use by Secretary of State.
Secretary of State
ssignment pplication
Department of Business Services
Trademark Division
501 S. Second St., Rm. 330
Springfield, IL 62756
217-524-0400
Payment may be made by check
or money order payable to Illinois
Secretary of State.
WHEREAS:
1. Name of Registrant/Owner of the Mark: _______________________________________________________________
Assignor
2. Business Address:
Mailing Address:
Street:
Street:
City:
State:
Zip:
City:
State:
Zip:
3. Present Owner is a (check one):
Corporation
Union
General Partnership
Limited Liability Partnership (LLP)
Individual
Association
Limited Partnership (LP)
Limited Liability Company (LLC)
Other (specify): _______________________________________________________________________________
4. a) If a Corporation, LP, LLP or LLC, indictate the State in which it is organized: ________________________________
b) If an LP or LLP, Name of one of the General Partners:__________________________________________________
5. Has adopted and used the Mark: _____________________________________________________________________
Name of Trademark or Service Mark
which is registered under number — — — - — — — as of ________________________________________________
Original Registration Date
(MM/DD/YYYY)
in the Office of the Illinois Secretary of State.
NOW, THEREFORE, to all whom it may concern:
Be it known that for good and valuable consideration, the receipt of which is hereby acknowledged, said owner has sold,
assigned and transferred the registered Mark, and by these presents does sell, assign and transfer unto:
6. Name of New Registrant: ____________________________________________________________________________
Assignee
7. Business Address:
Mailing Address:
Street:
Street:
City:
State:
Zip:
City:
State:
Zip:
Printed by authority of the State of Illinois. December 2012 — 1 — C 248.9
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