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This is a Mississippi form that can be used for Trade And Service Mark within Secretary Of State, Corporations.
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F0024 - Page 1 of 2 OFFICE OF THE MISSISSIPPI SECRETARY OF STATE P.O. BOX 136, JACKSON, MS 39205-0136 (601) 359-1633 Trade and Service Mark Assignment 1. Registration number 2. The mark to be assigned is 3. ASSIGNOR: Name Indicate if Assignor is a corporation or other entity and the State of incorporation or organization: id Incorporated State Organized 4. ASSIGNEE: Name State Indicate if Assignee is a corporation or other entity and the State of incorporation or organization: Incorporated Organized State State Address City, State, ZIP5, ZIP4 - 5. All right, title and interest in and to said mark, together with the good will of business in which the mark is used (or that part of the good will of the business connected with the use of the mark) is hereby assigned by (the Assignor) to (the Assignee). [F0024] Rev. 10/08 page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com F0024 - Page 2 of 2 OFFICE OF THE MISSISSIPPI SECRETARY OF STATE P.O. BOX 136, JACKSON, MS 39205-0136 (601) 359-1633 Trade and Service Mark Assignment By: Signature of Assignor (Please keep writing within blocks) Printed Name By: Signature of Assignee Title (Please keep writing within blocks) Printed Name Title ACKNOWLEDGMENT State of County of Sworn to and subscribed before me this Notary Seal day of Notary Signature , My commission expires INSTRUCTIONS: The above assignment must be signed by both the Assignor and the Assignee. If either is a corporation or other entity, the name of the corporation or entity is to be inserted as Assignor or Assignee with the signature of the proper authorities. Please enclose Filing Fee of $50.00 made payable to the Mississippi Secretary of State and mail it to P.O. Box 136 Jackson, Mississippi 39205-0136. [F0024] Rev. 10/08 page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com