Application For Registration Of Claim To Right Of Publicity
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Application For Registration Of Claim To Right Of Publicity Form. This is a Nevada form and can be use in Trademarks Secretary Of State.
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Tags: Application For Registration Of Claim To Right Of Publicity, Nevada Secretary Of State, Trademarks
ROSS MILLER
Secretary of State
555 East Washington Ave., #5200
Las Vegas, Nevada 89101
(702) 486 2880
Website: www.nvsos.gov
Application for
Registration of Claim
to Right of Publicity
(PURSUANT TO NRS 597.800)
USE BLACK INK ONLY - DO NOT HIGHLIGHT
ABOVE SPACE IS FOR OFFICE USE ONLY
1. Name of Claimant:
2. Address of Claimant:
3. The above listed claimant, being first duly sworn, under penalty of perjury, deposes and says that he is the:
Successor In Interest
(check only one box)
Licensee
of the deceased person identified below.
4. Legal name of the deceased person:
5. Professional name of the deceased person:
6. Date of death of deceased person:
7. The basis of the claimant's claim is as follows:
8. The following is a description of the rights claimed:
STATE OF
X
COUNTY OF
Signature of Claimant
This instrument was signed and sworn to before me on
by
Date
Claimant
Notary Stamp
Notary Signature
Filing Fee: $25.00
Nevada Secretary of State Right of Publicity
Revised on: 1-22-09
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