Assignment Of Mark Registration {INHS27}

FLORIDA DEPARTMENT OF STATE DIVISION OF CORPORATIONS Attached are the form and instructions to assign a trademark and/or service mark registration. x 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. x 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 (1/11) American LegalNet, Inc. www.FormsWorkFlow.com 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 American LegalNet, Inc. www.FormsWorkFlow.com 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: American LegalNet, Inc. www.FormsWorkFlow.com 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) Sworn to and subscribed before me on this day of , , (Name of Individual Signing) 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) Sworn to and subscribed before me on this day of , , (Name of Individual Signing) who is personally known to me (Notary Seal) whose identity I proved on the basis of Signature of Notary Public FILING FEE: $50 per class Division of Corporations P. O. Box 6327 Tallahassee, FL 32314 American LegalNet, Inc. www.FormsWorkFlow.com