Free TMSM-04 Application to Amend a Registered Trade or Service Mark - New Jersey

TMSM ­ 04 Rev 10/02

New Jersey Division of Revenue APPLICATION TO AMEND A REGISTERED TRADE OR SERVICE MARK
This form may be used by applicants seeking to amend a registered State trade or service mark pursuant to NJSA 56. Applicants are responsible for strict adherence to all requirements as set forth in State law. 1. Trade/Service Mark Number (as assigned by the Treasurer and listed on the Certificate of Registration) : 2. Owner Information: a. Name: (must match the name shown on the Division of Revenue's records) b. Business Address: (must match the address shown on the Division of Revenue's records)

3. Amendment Type: (check all that apply) _____ Owner Name Change _____ Owner Address Change
Note: This form may not be used to assign ownership --use Assignment Form TMSM-03 for assigning ownership of a registered mark. Also, an amendment shall not include alterations to the mark name or drawings/ facsimiles associated with the original filed application.

4. Details of Change: (indicate new name and/or address)

5. Signature(s): The mark is hereby amended.

_______________________________________
(Signature of Owner, or a Member of the Firm, or an Officer of the Corporation or Business Applying)

_______________
(Date)

(Rev 7/05)

Instructions for Form TMSM-04

Type or machine print all information except signatures and file the application in duplicate. Remittance/Fees: A check or money order signed and made payable to the NJ Division of Revenue must accompany the application. Base Filing Fee

1)

$50.00 per filing (includes one classification)

Premium Service Surcharges: 1) 2) $15.00 additional per filing for expedited handling (8.5 business hour processing for items delivered over the counter) $100.00 additional per filing for same day service (same day processing for items delivered over the counter)

Addresses: Regular service (regular mail) NJ Division of Revenue Po Box 453 Trenton, NJ 08646-0453 Expedited and same day service ** NJ Division of Revenue 33 West State Street, 5th Fl. Trenton, NJ 08608-1214 **Delivery by messenger or in person only; Do not use USPS overnight delivery.

THIS FORM SERVES TO SIMPLY FILE WITH THE TREASURER and DOES NOT REPLACE THE NEED FOR COMPETENT LEGAL ADVICE.