LANDS AND TRADEMARKS DIVISION STATE OF ALABAMA APPLICATION FOR ASSIGNMENT OF MARK WHEREAS, has adopted, used and is using a mark directly which is registered in the Alabama Secretary of State’s office, such registration being described as follows: MARK: _________________________________________________________________ REGISTRATION # _____________ DATE OF REGISTRATION: _______________ CLASS # _______ WHEREAS, is desirous of acquiring the mark and the registration thereof. NOW THEREFORE, for good and valuable consideration, receipt is hereby acknowledged, said assignor, does hereby assign all right, title and interest in and to the mark, together with the goodwill of the business symbolized by the mark, and the above identified registration thereof to: DATE: BY: Send application and filing fee of $30.00 (thirty dollars) to Secretary of State, P. O. Box 5616, Montgomery, AL 36103 REVISED 1/2005 American LegalNet, Inc. www.USCourtForms.com ASSIGNMENT INSTRUCTIONS Any mark, and its registration under Alabama law (Code of Alabama, §8-12-11), shall be assignable along with the goodwill of the business in which the mark is used, or with that part of the good will of the business connected with the use of and symbolized by the mark. Assignment shall be by instruments in writing, duly executed and are to be recorded with the Secretary of State upon the payment of a fee of $30.00, payable to the Secretary of State. Upon recording the assignment, the Secretary of State shall issue, in the name of the assignee, a new certificate for the remainder of the term of the registration or of the last renewal thereof. The enclosed is a suggested format. Please be sure to include the assignee’s and assignor’s complete addresses within the context of the assignment. If you have any questions, please contact this office for assistance. Lands & Trademarks Division P.O. Box 5616 Montgomery, AL 36103-5616 334-242-5325 American LegalNet, Inc. www.USCourtForms.com