COVER LETTER TO: Registration Section Division of Corporations SUBJECT: (Name of Mark) The enclosed Certificate of Change of Name of the Registrant or Applicant of a Florida Trademark and/or Service Mark Registration and fee(s) are submitted for filing. Please return all correspondence concerning this matter to: (Contact Person) (Firm/Company) (Address) (City, State and Zip Code) For further information concerning this matter, please call: at ( (Name of Contact Person) ) (Area Code and Daytime Telephone Number) Enclosed is a check for the following amount: $50 Filing Fee and Certificate of Registration (Free of Charge) $102.50 Filing Fee, Certified Copy, and Certificate of Registration (Free of Charge) MAILING ADDRESS: Registration Section Division of Corporations P. O. Box 6327 Tallahassee, FL 32314 STREET ADDRESS: Registration Section Division of Corporations Clifton Building 2661 Executive Center Circle Tallahassee, FL 32301 CR2E121 (1/11) American LegalNet, Inc. www.FormsWorkFlow.com CERTIFICATE OF CHANGE OF NAME OF THE REGISTRANT OR APPLICANT OF A FLORIDA TRADEMARK AND/OR SERVICE MARK REGISTRATION Pursuant to s. 495.081(3), Florida Statutes, the undersigned hereby submits this certificate to change the name of the registrant or applicant of the following Florida trademark and/or service mark registration: 1. Name of Mark: 2. Registration Number: 3. Date of Registration: 4. a. Name of owner as it appears on the trademark/service mark registration: b. Address of owner as it appears on the trademark/service mark registration: 5. a. New name of owner: b. New mailing address, if applicable: Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com SIGNATURE: Owner's Signature: Typed/Printed Name of Person Signing: STATE OF COUNTY OF Sworn to and subscribed before me on this day of , 20 . (Enter Name of Person Signing Above) who is personally known to me or proved on the basis of (Seal) whose identity I . Notary Public's Signature Notary Public's Printed Name My Commission Expires: (Attach additional sheet if necessary) Filing fee: Certificate of Registration: Certified Copy (optional): $50.00 Issued Free of Charge $52.50 Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com