r Please mail egistration and make check payable to: Secretary of State / Trademark Division 1700 W Washington 7th Fl. Phoenix, Arizona 85007 Walk-in service: Phoenix Tucson: 400 W. Congress, Ste. 252 (602) 542-6187 (800) 458-5842 (within Arizona) Filing Fee: $15.00 ttenneB neK 1 1 1: 30 mooR ,. lF ts , notgnihsaW . W 007 , , . ASSIGNMENT OF TRADEMARK (A.R.S. §44-1446) Please print clearly or type. Renewal notices are dependent on accurate information. Please update your records if you relocate. Registration Number: Description of Mark: Assignor: Present Trademark Owner on File Mailing Address Street or Box Number City State Zip Assignee: Name of individual or business entity to whom the mark will be assigned Assignee: Please check one. Do not select “Corporation or L.L.C. if you are not currently incorporated or your application will be returned to you. Individual Foreign corporation licensed to do business in Arizona Partnership Association Organization Corporation LLC Other Mailing Address: Street or Box Number City State Zip Phone number (optional): Be it known for good and valuable consideration in hand paid, the receipt of which is hereby acknowledged, the identified Assignor together with the good will of the business in connection with which the said trademark is used by these present does sell, assign and transfer unto the identified Assignee the entire right, title and interest in and to the identified trademark. Assignee’s Printed Name Assignor’s Printed Name Assignee’s Signature Assignor’s Signature State of Arizona State of Arizona County of County of Acknowledged before me on this ______ day of Acknowledged before me on this ______ day of _________________________, 20__ _________________________, 20__ Notary Public TN asgttm Revision 093009 _ _ Notary Public American LegalNet, Inc. www.FormsWorkFlow.com