Free Assignment - Florida

FLORIDA DEPARTMENT OF STATE DIVISION OF CORPORATIONS

Attached are the form and instructions to assign a trademark and/or service mark registration. · The fee to file the assignment is $50 per class. Please make the check payable to the Florida Department of State. Please be advised that a certificate reflecting the name and address of the new owner is free of charge and will automatically be returned with your letter of acknowledgment. · The assignment must be signed by the assignor (the old owner) and the assignee (the new owner). Both signatures must be notarized. Any further inquiries concerning this matter should be directed to the Registration Section by calling (850) 245-6051.

STREET/COURIER ADDRESS: Registration Section Division of Corporations Clifton Building 2661 Executive Center Circle Tallahassee, Florida 32301

MAILING ADDRESS: Registration Section Division of Corporations P.O. Box 6327 Tallahassee, Florida 32314

INHS27 (1/07)

COVER LETTER
TO: Registration Section Division of Corporations

SUBJECT: (Name of Mark to be assigned)

Dear Sir or Madam: The enclosed Mark Assignment and fee(s) are submitted for filing. Please return all correspondence concerning this matter to the following:

(Name of Person)

(Firm/Company)

(Address)

(City/State and Zip Code)

For further information concerning this matter, please call:

(Name of Person)

at ( ) (Area Code & Daytime Telephone Number) MAILING ADDRESS: Registration Section Division of Corporations P.O. Box 6327 Tallahassee, Florida 32314

STREET/COURIER ADDRESS: Registration Section Division of Corporations Clifton Building 2661 Executive Center Circle Tallahassee, Florida 32301

FILING FEE: $50 per class

ASSIGNMENT OF MARK REGISTRATION
1. The mark to be assigned is: 2. Registration Number: 3. (a) Assignor's name:

(b) Assignor's Business Address:

City/State/Zip

If Different, Assignor's Mailing Address:

City/State/Zip

4. (a) Assignee's name:

(b) Assignee's Business Address:

City/State/Zip If Different, Assignee's Mailing Address:

City/State/Zip (c) Assignee's telephone number: ( Individual Corporation General Partnership ) Joint Venture Union Limited Liability Company Other:

Limited Partnership

If other than an individual, (1) Florida registration/ document number: (3) Federal Employer Identification Number:

(2) Domicile State:

5. All right, title and interest in and to said 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) is hereby assigned by (the Assignor) to (the Assignee) .

6. Assignor's Signature:

By (Typed or Printed Name of Person Signing Above)

On this day of personally appeared before me, who is personally known to me (Notary Seal)

,

,

whose identity I proved on the basis of

Signature of Notary Public 7. Assignee's Signature:

By (Typed or Printed Name of Person Signing Above) On this day of personally appeared before me, who is personally known to me (Notary Seal) Signature of Notary Public FILING FEE: $50 per class Division of Corporations P. O. Box 6327 Tallahassee, FL 32314 , ,

whose identity I proved on the basis of