r Please mail egistration 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: $10.00 ttenneB neK R, 1 1 30 moo . lF ts , notgnihsaW . W 007 : xineohP 1 , . ASSIGNMENT OF TRADE NAME (A.R.S. § 44-1460.03) Please print clearly or type to avoid errors in registration. Trade Name: Registration #: Assignor: Present Trade Name Owner on File Mailing Address Street or Box Number City State Zip Assignee: Name of individual or business entity to whom the name 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 Partnership Corporation Foreign corporation licensed to do business in Arizona Association Organization 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 trade name 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 trade name. 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 asgttn Revision 093009 _ _ Notary Public American LegalNet, Inc. www.FormsWorkFlow.com