Arkansas Secretary of State 1401 W. Capitol, Ste 250 Little Rock, AR 72201-1094 501-682-3409 www.sos.arkansas.gov Assignment of Registration of Trademark or Service Mark For information on Trademark Assignments, see the Trademark FAQs available at: http://www.sos.arkansas.gov/BCS/Pages/trademarkServiceMark.aspx 1.Check one:Trademark(OR) Service Mark 2.Registration Number:3.Date of Registration: (Month/Day/Year) 4.Assignor (Current owner & user of the mark): Street Address: City: State: Zip Code: Contact Telephone Number: 5.Assignee (New owner of the mark): Street Address: City: State: Zip Code: Contact Telephone Number: Whereas (Name of Assignor) has adopted, used, and is using theaforementioned mark which is filed with the Arkansas Secretary of State; and Whereas (Name of Assignee) is desirous of acquiring said markand registration thereof: For good and valuable consideration, receipt of which is hereby acknowledged,said Assignor does hereby assign unto said Assignee all rights, title, and interest in and to said mark,together with the good will of the business in which the trademark is used (or that part of the goodwill ofthe business connected with the use of and symbolized by the trademark) and the registration thereof. AFFIDAVIT I, the undersigned, being first duly sworn, state that I am the owner of the mark or the lawfully authorized representative of the owner, and that I have the authority to make this assignment. The information provided herein is true to the best of my knowledge and is made with the intent to file with the Arkansas Secretary of State. I understand that the statements made herein are under oath, and that knowingly making a false statement here is a Class C Felony pursuant to Ark. Code Ann. 247 5-53-102. Assignor222s Signature Title, if applicable 6.State of Arkansas County of {Seal} Subscribed and sworn before me, a Notary Public, on this day of ,20 My Commission Expires: Notary Public: Assignment Fee: $20.00 payable to the Arkansas Secretary of State Questions? Check out the Trademark FAQs online! Rev. American LegalNet, Inc. www.FormsWorkFlow.com