TRADEMARK REGISTRATION CHANGE GENERAL INFORMATION Information about the holder of an Alaska trademark registration may be changed by completing and submitting form 08-570, Trademark Registration Change. Allowable changes have to do with changes in the name, organization type, or actual owner of the mark. Any other change, excepting cancellation of the registration, would most likely require a new Trademark Registration Application, form 08-565. INSTRUCTIONS FOR COMPLETING FORM • Complete the Original Registrant Information section This information is the same information found on your Certificate of Trademark Registration. • Complete the Change Information section If the ownership has changed, check the box indicating assignment of registration. Assignment occurs when the form of organization of a business changes as well as when a business is sold. By statute, assignment must occur in the three months preceding or three months following change of ownership of the business or line of business connected with the use of the mark. The assignee name is the name of the individual, corporation, partnership, or other organization to which ownership of the mark is being assigned. The business address is the mailing address for corresponding with the assigned owner of the mark. Organized entities (i.e. not individuals) indicate the state or territory of domicile for the organization. List the names of the general partners for a partnership. If the ownership has not changed, check the box indicating name or address change. If the name has changed, enter the new name. If the address has changed, enter the new address. If the state of domicile has changed, enter the new state. If the partners have changed, enter the names of all general partners. • Complete the Signature Affirming Accuracy of Information section Sign the application. The signature affirms that the information is accurate. The application must be signed by the individual, or by a corporate officer, general partner, or member of the original registrant. Enter the name of the signatory. Enter the title of the signatory. Enter a contact telephone, in case the division needs some clarification of information. Including this with the application will speed resolution of any problems that might exist. • Send completed application to State of Alaska, Division of Banking, Securities and Corporations PO Box 110808 Juneau AK 99811 – 0808 Enclose a check or money order for $25, payable to the State of Alaska. • If more space is required, attach an 8 ½” X 11” sheet of paper with the additional information, and indicate which section of the application it applies to. 08-570 (Rev. Jul/2001) American LegalNet, Inc. www.USCourtForms.com TRADEMARK REGISTRATION CHANGE Provide necessary information as the instructions indicate. Please type or print, except for the signature. Original Registrant Information Alaska Registration Number: Expiration date: Name of registrant: Business address: City, state, postal code: Change Information Assignment of Registration (Ownership Has Changed) Name of assignee: Business address: City, state, postal code: If corporation or partnership, state of domicile: If partnership, names of general partners: Registrant Name or Address Change (Ownership Has NOT Changed) New name: New address: New city, state, postal code: If corporation or partnership, state of domicile: If partnership, names of general partners: Signature Affirming Accuracy of Information Signed: Printed name: STATE USE ONLY Title: Signer must be: the applicant or a member of the firm or an officer of the corporation, partnership or association of the original registrant. Phone to call if there are questions: Date received Check # Dollar amount Cash Return form and $25.00 payment to Dept. of Community and Economic Development Corporations Section PO Box 110808 Juneau AK 99811-0808 Card type Authorization # Registration # Registration Date The change will not be processed if the fee is not enclosed, payable to the State of Alaska. Expiration Date 08-570 Revised 7/2001 American LegalNet, Inc. www.USCourtForms.com