Arizona Trademark Amendment Form

To change certain details of a trademark, the holder must fulfill this form and submit it to the Secretary of State’s office. Holder must also pay for the $3.00 filing fee.Download

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DO NOT 	WRITE IN 	THIS 	SPACE	 	
O f f i c e   F o r m   S O S B S T N	A. d o c  	 	S t a t e   o f   A r i z o n a  	- T r a d e   N a m e	- T r a d e   M a r k   A m	e n d m e n t	 A p p l i c a t i o n                                                                                      	                 	 	
 	
 
State of Arizona	 	
Amen	dment 	Application	 	
 	
 	 	FOR OFFICE 	USE ONLY 	– REV. 10/01/2011	 	
Mail to: Arizona Secretary of State Ken Bennett	 	Attention: Business Services, Trade Name Division	 	1700 W . W ashington Street, 7th Fl., Phoenix, AZ 85007	-2888	 	(602) 542	-6187	  (800) 458	-5842 (within Arizona)	 	W ebsite: 	www.azsos.gov	 	
The registration of a Trade Nam e and Tradem ark is 	not legally required in Arizona	,  	but is an accepted business practice. The registration of a Trade Nam e is 	a public record and does not 	constitute exclusive rights to the holder of the nam e.	 	
 	
 	 	
TRADE 	NAME	/T	RADE 	MARK	 AMENDMENT	 APPLICATION	 	
About this Application	 	How to complete this form	 	 This form is for	 an amendment	 of a Trade Name 	or Trade Mark.	. 	 Filing 	Fee:	  $3.00	 	Payment:	  Checks or money orders shall be made payable to the 	Secretary of State	. Credit cards are not accepted.	 	Processing:	  2-3 weeks	 	 	
 To avoid registration errors	 please 	writ	e legibly or computer generate 	this	 	application	. This f orm has been	 designed to be filled out and printed online 	at the website ref erenced above. 	 	 Read this app	lication carefully, and fill in all blank spaces.	 	File by mail 	with payment 	to the address above, or	 	Return in person at the f ollowing locations:	 	PHOENIX 	- State C	apitol 	Executive T ower	 	1700 W . W ashington Street	 	First Floor, Room 103	 	
TUCSON 	- Arizona State Complex 	Building	 	400 W . Congress	 	Second Floor, Room 252	 	Open Monday 	- Friday, 8 a.m. 	- 5 p.m.	, except state holidays.	 	
1. Name, title or designation to be 	Amend	ed	 	SPACE 	BELOW  	FOR OFFICE 	USE ONLY 	- VALIDAT ION 	AREA	 	
	 Trade Name	
 	
	 Trade Mark	
 	 	
File Number:	 	
Trade Name or 	Trade Mark Description:	 	
If owner is an individu	al, list the individual’s name i	f two applicants, list both; if the owner is a corporation, li	st the corporation’s name; etc.	 	
1st Applicant	 	2nd Applicant	 	
2. Address Change	 	
 FORMER MAILING ADDRESS	 	 CITY	 	 STATE	 	 ZIP CODE	 	
 NEW  MAILING ADDRESS	 	 CITY	 	 STATE	 	 ZIP CODE	 	
3. Legal Name Change ~ Check appropriate boxes, fill in name change, attach name c	hange documentation.	 	
Reason for name change	 	
(You must include a copy of U.S. ID)	 	
 	 FORMER NAME	 	
	 Marriage	 		 Divorce	 	 	  NEW  NAME:	 	
	 Other	
 	
4. Other Changes	 	
	 Phone Number:	
 	 
	 Nature of Business	
 	
5. Applicant’s Signature 	nIf two applicants are listed above, both must sign.	   	Date	 	
1st Signer	’s Printed	 Nam e	 	Signature	 	Month	 	Day	 	Year	 	
2nd Signer	’s Printed	 Nam e	 	Signature	 	Month	 	Day	 	Year	 	
State of Arizona	 	 	 	County of ___________________ 	 	) ) 	 	On this 	______ day of ________________________, 20 ____	 	
 	 	
 	 	                          	 (Name 	of Person Appearing Before Notary	) 	
 	 	personally appeared befo	re m e and acknowledged that he/she signed this 	document for it’s stated purpose.	 	 	
 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	Notary Public