- 1 -
|
OFFICE OF SECRETARY OF STATE THIS SPACE FOR OFFICE USE ONLY
CORPORATIONS DIVISION AMOUNT
2 Martin Luther King Jr. Dr. SE RECEIVED:______________ I NITIALS :_______
Atlanta, Georgia 30334 C
Suite 313 West Tower HECK/
CC/M.O.#:_____________________________
(404) 656-2817
http://sos.ga.gov/ DOCKET
Secretary of State NUMBER :______________________________
ASSIGNMENT FORM
TRADEMARK OR SERVICE MARK FILING EE F :$15.00
IN COMPLIANCE WITH THE REQUIREMENTS OFO.C.G.A.ยง10-1-446, THE UNDERSIGNED ,HAVING ADOPTED AND USED A TRADEMARK
OR SERVICE MARK IN THIS STATE FOR PURPOSES PROVIDED IN THAT CODE CHAPTER ,DOES HEREBY CERTIFY THE FOLLOWING :
1. ____________________________________________________________________________________________________
ASSIGNOR (CURRENT REGISTERED WNERO )
2. ____________________________________________________________________________________________________
PRINCIPAL BUSINESS DDRESSA
3. ____________________________________________________________________________________________________
ASSIGNEE (NEW OWNER )
IF A CORPORATION ,ENTER STATE OR COUNTRY OF INCORPORATION:_____________________________
4. ____________________________________________________________________________________________________
PRINCIPAL BUSINESS DDRESSA
5. ____________________________________________________________________________________________________
DESCRIPTION OF MARK
A. ______________________________________
REGISTRATION NUMBER
B. ______________________________________
INITIAL REGISTRATION ATED
C. ______________________________________
EXPIRATION DATE
BE IT KNOWN FOR AND IN CONSIDERATION OF MONIES ,AND/OR OTHER GOOD AND VALUABLE CONSIDERATION TO IT IN HAND PAID ,
THE RECEIPT OF WHICH IS HEREBY ACKNOWLEDGED ,SAID ASSIGNOR DOES HEREBY SELL AND, OR/ ASSIGN AND, OR/TRANSFER UNTO
SAID ASSIGNEE THE ENTIRE RIGHT TITLE, AND INTEREST IN AND TO THE SAID MARK AND REGISTRATION THEREOF TOGETHER, WITH
THE GOOD WILL OF THE BUSINESS IN WHICH THE MARK IS USED OR WITH THAT PART OF THE GOOD WILL OF THE BUSINESS
CONNECTED WITH THE USE OF AND SYMBOLIZED BY THE MARK.
SIGNATURE OF ASSIGNOR /OWNER ____________________________________________________
PRINT OR TYPE NAME ____________________________________________________
TITLE (IF SIGNING FOR ENTITY ) ____________________________________________________
STATE OF ______________________________ COUNTY OF ______________________________
SWORN TO AND SUBSCRIBED BEFORE ME THIS______ DAY OF_____________________,20____.
_________________________________________ MY C OMMISSION XPIRESE :_________________________________
NOTARY PUBLIC
Return this completed and notarized form and a $15.00 filing fee to the Secretary of State at the above address before the expiration
date. Fees are non-refundable.
FORM TM03
(Rev. 10/2018)
|