CSCL/CD-603 (Rev. ) MICHIGAN DEPARTMENT OF LICENSING AND REGULATORY AFFAIRSCORPORATIONS, SECURITIES & COMMERCIAL LICENSING BUREAU Date Received(FOR BUREAU USE ONLY) Pursuant to the provisions of Act 242, Public Acts of 1969, as amended, the undersigned executes the following affidavit:2.The Mark consists of: 1.This affidavit is for the purpose of assigning a: (Check only one) ASSIGNMENT OF TRADEMARK/SERVICE MARK(Please read information and instructions on last page) Trademark Service Mark a)Please mark only one: Words Only Words and Design Design Only b)The words in the mark are (if applicable):2.The Mark consists of:3.The Mark identification number is:4.The classification code of the mark is: (Only one class should be listed per document)5.Assignor:a)The name of the individual or business entity who currently owns the Mark is:b)The business address of the owner is:6.Assignee:a)The name of the individual or business entity who is assigned to the Mark is: (Only one name should be provided)b)The business address of the assignee is: SignatureType or Print NameType or Print Title Complete item 7 only if the assignee name in item 6a is a corporation. 7.The state of incorporation is:Signed thisday of, . 8.The assignor does hereby assign to said assignee the mark, its registration, and (check one only): The goodwill of the business in which the mark is used. The part of the goodwill of the business connected with the use of and symbolized by the mark. American LegalNet, Inc. www.FormsWorkFlow.com Limited Liability Company - by a manager if management is vested in one or more managers or by a member if management is reserved for members. Submit with check or money order by mail: Michigan Department of Licensing and Regulatory Affairs Corporations, Securities & Commercial Licensing Bureau Corporation Division P.O. Box 30054 Lansing, MI 48909To submit in person:2501 Woodlake CircleOkemos, MI 48864Telephone: (517) 241-6470 Fees may be paid by check, money order, VISAMasterard when delivered in person to our office. LARA is an equal opportunity employer/program. Auxiliary aids, services and other reasonable accommodations are available upon request to individuals withdisabilities. 5. Item 2 - Check the box next to the type of mark being assigned. If the mark contains words, complete item 2(b). 9.FEE: Make remittance payable to the State of Michigan............................................................................................$15.00INFORMATION AND INSTRUCTIONS1.This assignment cannot be recorded until this form, or a comparable document, is submitted. CSCL/CD-603 (Rev. )Preparer's NameBusiness telephone number( )8.This Assignment must be signed in ink by: Individual - by the assignor. Corporation - by an authorized officer or agent. Partnership - by a partner.7. Item 4 - State the classification number for the goods or services in connection with which the mark is used. This numbermay be obtained from the Certificate of Registration for the mark. Only one classification code should be provided perdocument. 6.Item 3 - Enter the identification number previously assigned by the Bureau.4.This form is to be used pursuant to Section 6 of Act 242 of 1969 for the purpose of assigning a mark and its registration.The assignment must be either the goodwill of the business in which the mark is used or the part of the goodwill of thebusiness connected with the use of and symbolized by the mark.3. Since this document will be maintained on electronic format, it is important that the filing be legible. Documents with poorblack and white contrast, or otherwise illegible, will be rejected. 2. Submit one original of this document. Upon filing, the original and a Certificate attesting to the assignment will be returnedto the assignee. American LegalNet, Inc. www.FormsWorkFlow.com