Free TMSM-05 Application to Cancel a Registered Trade or Service Mark - New Jersey

TMSM ­ 05 Rev 10/02

New Jersey Division of Revenue APPLICATION TO CANCEL A REGISTERED TRADE OR SERVICE MARK
This form may be used by applicants seeking to cancel a registered State trade or service mark pursuant to NJSA 56. Applicants are responsible for strict adherence to all requirements 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.Signature(s): The undersigned request that the mark be cancelled.

_______________________________________
(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-05

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) $15.00 additional per filing for expedited handling (8.5 business hour processing for items delivered over the counter) 2) $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.