Free ASSIGNMENT OF REGISTRATION - Nebraska

ASSIGNMENT OF REGISTRATION
John A. Gale, Secretary of State Room 1301 State Capitol, P.O. Box 94608 Lincoln, NE 68509 (402) 471-4079
http://www.sos.state.ne.us TRADE MARK OR SERVICE MARK

Submit in Duplicate Circle the type of filing to be assigned: Trade Mark or Service Mark Mark to be assigned________________________________________________________ Whereas________________________________ ________________________________
Name of Assignor State Street Address

_________________________________________________ has adopted, used and is
City Zip

using the mark which is registered with the Nebraska Secretary of State, and whereas: ____________________________________ ___________________________________
Name of Assignee State Street Address

_________________________________________________ desires to acquire said mark
City Zip

and registration thereto: Now, therefore, for good and valuable consideration, receipt of which is hereby acknowledged, ______________________________________ does hereby assign to
Name of Assignor

______________________________________ all right, title and interest in and to said
Name of Assignee

mark. ______________________________________ Signature of Assignor State of ____________________ County of __________________ Subscribed and sworn to before me this _______ day of __________________, ______
Year

Affix Notary Seal here

_____________________________________ Notary Public Revised 09/09/2005

FILING FEE: $5.00