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Trademark Or Servicemark Assignment Application TM-SM-35a - Illinois
| Trademark Or Servicemark Assignment Application Form. This is a Illinois form and can be used in Trademark Secretary Of State . |
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TM/SM-35a Secretary of State Department of Business Services Trademark Division 501 S. Second St., Rm. 330 Springfield, IL 62756 217-524-0400 www.cyberdriveillinois.com State of Illinois Trademark or Service Mark Assignment Application FILE #: This space for use by Secretary of State. Type, Laser Print or Legibly Print in black ink. This space for use by Secretary of State. Payment may be made by check or money order payable to Illinois Secretary of State. Assignment Fee: $5 See additional page for instructions. WHEREAS: 1. Name of Registrant/Owner of the Mark: _______________________________________________________________ Assignor 2. Business Address: Street: Mailing Address: Street: City: State: Zip: City: State: Zip: 3. Present Owner is a (check one): Ë Corporation Ë Union Ë General Partnership Ë Limited Liability Partnership (LLP) Ë Individual Ë Association Ë Limited Partnership (LP) Ë Limited Liability Company (LLC) Ë Other (specify): _______________________________________________________________________________ 4. a) If a Corporation, LP, LLP or LLC, indictate the State in which it is organized: ________________________________ b) If an LP or LLP, Name of one of the General Partners:__________________________________________________ 5. Has adopted and used the Mark: _____________________________________________________________________ Name of Trademark or Service Mark which is registered under number -- -- -- - -- -- -- as of ________________________________________________ Original Registration Date (MM/DD/YYYY) in the Office of the Illinois Secretary of State. NOW, THEREFORE, to all whom it may concern: Be it known that for good and valuable consideration, the receipt of which is hereby acknowledged, said owner has sold, assigned and transferred the registered Mark, and by these presents does sell, assign and transfer unto: 6. Name of New Registrant: ____________________________________________________________________________ Assignee 7. Business Address: Street: Mailing Address: Street: City: State: Zip: City: State: Zip: Printed by authority of the State of Illinois. October 2012 -- 1 -- C 248.8 American LegalNet, Inc. www.FormsWorkFlow.com 8. New Owner is a (check one): Ë Corporation Ë Union Ë General Partnership Ë Limited Liability Partnership (LLP) Ë Individual Ë Association Ë Limited Partnership (LP) Ë Limited Liability Company (LLC) Ë Other (specify): _______________________________________________________________________________ 9. a) If a Corporation, LP, LLP or LLC, indictate the State in which it is organized:________________________________ b) If an LP or LLP, Name of one of the General Partners: _________________________________________________ 10. The entire right, title and interest in and to the said _____________________________________________________ Name of Trademark or Service Mark and the registration thereof, together with the goodwill of the business in connection with which the said mark is used, or with that part of the goodwill of the business connected with. The undersigned hereby affirms, under penalties of perjury, that the facts stated herein are true. X _____________________________________________ Signature of Assignor (Old Owner) ____________________________________________ Typed or Printed Name of Assignor ______________________________________________ Official Capacity ____________________________________________ Contact Phone Number INSTRUCTIONS FOR ASSIGNMENT APPLICATION [TM/SM-35a] NOTES: · An application for assignment of a registration must be on a form provided by the Illinois Secretary of State. This application must include the goodwill of the business in which the Mark is used, or with the part of the goodwill of the business connected with the use of and symbolized by the Mark. A $5 Recording Fee must accompany the completed application in the form of a check or money order payable to Illinois Secretary of State. The assignment form must be typed, laser-printed or legibly printed in black ink. · · INSTRUCTIONS: 1. 2. 3. Accurate information for the current Registrant, i.e., the Assignor, must be given in items 1 through 4. The name of the Mark, the registration number and the original date of registration must appear where indicated in item 5. Items 6 through 10 must exhibit accurate information about the new Owner/Assignee. Signature and Contact Information: The Assignor or the Attorney-in-Fact for the Assignor must sign the assignment application. The capacity in which the person is signing must be given, i.e., Registrant, Officer, Attorney-in-Fact. Photocopied, stamped or faxed signatures are not accepted. Duration and Renewal: A certificate indicating the assignment of ownership may be issued for the remainder of the current term of the Mark. An assignment of any registration under this Act shall be void as against any subsequent purchaser for valuable consideration without notice, unless it is recorded with the Secretary of State within three months after the date thereof or prior to such subsequent purchase. American LegalNet, Inc. www.FormsWorkFlow.com
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