r Please mail egistration and make check payable to: Secretary of State / Trade Name Division 1700 W Washington 7th Fl. Phoenix, Arizona 85007 Walk-in service : Tucson: 400 W. Congress, Ste. 252 (602) 542-6187 (800) 458-5842 (within Arizona) Filing Fee: $15.00 ttenneB neK 1 1 P: R, 1 30 moo . lF ts , notgnihsaW . W 007 xineoh , . APPLICATION FOR RENEWAL OF MARK (A.R.S. § 44-1445) This renewal application only satisfies the continuation of your Trademark. Any changes of ownership of the Trademark must be submitted on a Trademark Assignment form. If you do not wish to renew your Trademark or fail to file this application by the expiration date, please understand that the Trademark will expire and become available for public registration. Registration #: Accurate word description of Trademark: Your certificate and future renewal notices are dependent on accurate address information including suite numbers. Please update your record if you relocate. Applicant(s) Name: Current owner(s) on record Applicant must check one. Individual LLC Partnership Arizona Corporation Association Other Foreign Corporation licensed in Arizona. State of Incorporation: Mailing Address: Street or Box Number Is this a new address? Yes City State Zip No Phone (Optional): Original date of Registration: Date of first use in Arizona: Please attach specimen or facsimile of trademark on 8 ½ by 11 inch paper. Applicant’s Printed Name Applicant’s Signature Date Applicant’s Printed Name Applicant’s Printed Name Date TM rnwtm Revision 093009 American LegalNet, Inc. www.FormsWorkFlow.com