Trade And Service Marks - Assignment Or Cancellation
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Trade And Service Marks - Assignment Or Cancellation Form. This is a Oregon form and can be use in Business Registry Secretary Of State.
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Tags: Trade And Service Marks - Assignment Or Cancellation, 172, Oregon Secretary Of State, Business Registry
Phone: (503) 986-2200
Fax: (503) 378-4381
Secretary of State
Corporation Division
255 Capitol St. NE, Suite 151
Salem, OR 97310-1327
FilingInOregon.com
Trade and Service Marks—Assignment or Cancellation
Check the appropriate box below:
TRADE AND SERVICE MARK ASSIGNMENT
(Complete only 1, 2, 3, 4, 5, 6, 7, 8, 9, 12)
TRADE AND SERVICE MARK CANCELLATION
(Complete only 1, 2, 3, 4, 10, 11, 12)
REGISTRY NUMBER:
For office use only
Please Type or Print Legibly in Black Ink. Attach Additional Sheet if Necessary.
1)
CORRESPONDENT NAME AND MAILING ADDRESS
2)
OWNER OR ASSIGNOR’S NAME AND ADDRESS
3)
4)
DATE MARK WAS ORIGINALLY FILED
TRADE OR SERVICE MARK DESCRIPTION
ASSIGNMENT ONLY
CANCELLATION ONLY
5)
CLASS NUMBER(S) FOR WHICH MARK WAS REGISTERED
10) REGISTRY NUMBER
6)
NAME AND BUSINESS ADDRESS OF ASSIGNEE (New Owner)
11) Execution
Signature:
Date:
7)
IF THE ASSIGNOR IS A BUSINESS, ENTER THE STATE OF
FORMATION.
8)
IF THE ASSIGNEE IS A BUSINESS, ENTER THE STATE OF
FORMATION.
9)
EXECUTION
Now, therefore, for good and valuable consideration, receipt of which is
hereby acknowledged, ASSIGNOR does hereby assign onto the
ASSIGNEE all right, title, and interest in and to the mark, together with the
good will of the business in which the mark is used (or that part of the
good will of the business connected with the use of and symbolized by the
mark), and the registration thereof.
FEES
Required Processing Fee
$50
Processing Fees are nonrefundable.
Please make check payable to
“Corporation Division.”
Assignor Signature:
Title:
Date:
In accordance with Oregon Revised Statute 192.410-192.490, the information on this application is public record.
We must release this information to all parties upon request and it will be posted on our website.
12) CONTACT NAME (To resolve questions with this filing.)
DAYTIME PHONE NUMBER
NOTE:
Fees may be paid with VISA or
MasterCard. The card number and
expiration date should be submitted
on a separate sheet for your
protection.
(Include area code.)
172 (Rev. 5/07)
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