APPLICATION TO CHANGE NAME OF REGISTRANT OR APPLICANTTRADEMARK/SERVICE MARK REGISTRATIONSTATE OF NEW MEXICOThis form may only be used by a registrant or applicant of a trademark/service mark to change the name of theperson to whom the mark was issued or for whom an application was filed. If the mark is changed or if the kindof goods or services is expanded from that set forth in the original registration application, you must file a newApplication for Registration. Complete all items on the application. The application must be signed by anindividual registrant or applicant, general partner, or officer of a corporation or an association. Pursuant to the NewMexico Trademark Act, the undersigned hereby amends the registration of its trademark/service mark.1. Name of Trademark/Service Mark as registered: 2. File Number: 3. A Certificate of Registration was issued to the registrant or applicant under the name of: 4.The registrant222s or applicant's name has been changed to: 5.The registrant222s or applicant's address has been changed to: 6.Contact person and mailing address, if different from above: I hereby swear or affirm under penalty of perjury that the information provided is true, correct and complete andfurther that, I, or the person or entity I represent, is now using in the State of New Mexico and has heretoforeregistered the trademark/service mark identified above.By: Applicant Signature Title DateBy: ( ) Please Print Applicant222s Full NamePhone Number Submit application and $25.00 recording fee to: Office of the Secretary of State 325 Don Gaspar, Suite 301Santa Fe, New Mexico 87503Form TK3 (October 2003) American LegalNet, Inc. www.FormsWorkFlow.com