Free Application for Renewal of a Trademark - Arizona

Please mail Registration and make check payable to: Secretary of State Ken Bennett / Trade Name Division 1700 West Washington 7th Fl. Phoenix, Arizona 85007 Walk-in service: 14 N. 18th Ave., Phoenix, Arizona Tucson Office: 400 W. Congress, Ste. 252 (602) 542-6187 (800) 458-5842 (within Arizona) Filing Fee: $15.00

APPLICATION FOR RENEWAL OF MARK (A.R.S. §44-1445) This renewal application only satisfies the continuation of your Trademark. Any changes of ownership of the Trademark must be submitted on a Trademark Assignment form. If you do not wish to renew your Trademark or fail to file this application by the expiration date, please understand that the Trademark will expire and become available for public registration. Registration #: Accurate word description of Trademark:

Your certificate and future renewal notices are dependent on accurate address information including suite numbers. Please update your record if you relocate. Applicant(s) Name: Current owner(s) on record Applicant must check one. Individual LLC Partnership Arizona Corporation Association Other Foreign Corporation licensed in Arizona. State of Incorporation: Mailing Address: Street or Box Number Is this a new address? Phone (Optional): Original date of Registration: Date of first use in Arizona: Please attach specimen or facsimile of trademark on 8 ½ by 11 inch paper. Applicant's Printed Name Applicant's Printed Name Applicant's Signature Applicant's Printed Name Date Date Yes No City State Zip