Connecticut Trademark Assignment Form

If a person who owns a trademark that is registered in the State of Connecticut wishes to transfer that trademark to another person/entity, the following form has to be used. Complete the form and send it along with a $50 filing fee.

Extracted Text for Proper Search

ASSIGNMENT OF REGISTERED MARK
USE INK. COMPLETE ALL SECTIONS. PRINT OR TYPE. ATTACH 81/2 X 11 SHEETS I\
F NECESSARY.
ADDRESS:
CITY:
STATE:ZIP:
FILING PARTY 	(CONFIRMATION WILL BE SENT TO THIS ADDRESS)	:	
NAME:	
FILING FEE: $50 
EXCEPTION: $25.00 FILING FEE FOR 
CERTIFICATION AND COLLECTIVE MARK 
MAKE CHECKS PAYABLE TO "SECRETARY OF 
THE STATE" 
 	
1. CURRENT NAME OF RECORD OWNER:
2. STATE OF FORMATION OF THE OWNER (IF OTHER THAN A NATURAL PERSON): 
3. CONNECTICUT REGISTRATION NUMBER:
THE ABOVE NAMED OWNER OF THE MARK (THE ASSIGNOR), HEREBY ASSIGNS TO TH\
E ASSIGNEE AND NEW 
OWNER NAMED BELOW, ALL RIGHTS, TITLE AND INTEREST TO AND IN MARK, TOGETH\
ER WITH THE GOOD WILL 
OF THE BUSINESS SYMBOLIZED BY THE MARK, ALONG WITH THE REGISTRATION THER\
EOF.
   4.  NAME OF ASSIGNEE: 
 
ADDRESS:
CITY:
STATE: ZIP:
5. ADDRESS OF ASSIGNEE:
   6. STATE OF FORMATION OF THE ASSIGNEE  (	IF OTHER THAN A NATURAL PERSON):	 
 	
FORM TMAS-1-1.0 
Rev. 7/2010	PAGE 1 OF 2	
SECRETARY OF THE STATE OF CONNECTICUT 
MAILING ADDRESS: COMMERCIAL RECORDING DIVISION, CONNECTICUT SECRETARY OF THE STATE, P.O. \
BOX 150470, HARTFORD, CT 06115-0470  
DELIVERY ADDRESS: COMMERCIAL RECORDING DIVISION, CONNECTICUT SECRETARY OF THE STATE, 30 T\
RINITY STREET, HARTFORD, CT 06106  
PHONE: 	
860-509-6003  	WEBSITE: 	www.concord-sots.ct.gov

SIGNATORY	NAME OF SIGNATORY	TITLE OF SIGNATORY  	
(If Applicable)	SIGNATURE	
      ASSIGNOR
     ASSIGNEE
 THE  ASSIGNOR MUST SUBMIT THREE SPECIMENS OR PHOTOGRAPHS OF THE MARK AC\
TUALLY USED IN  
 THIS STATE.	
FORM TMAS-1-1.0 
Rev. 7/2010 	  PAGE 2 OF 2   
 7. EXECUTION:  
  WE, THE ASSIGNOR AND THE ASSIGNEE, HEREBY DECLARE UNDER THE PENALTIES \
OF FALSE STATEMENT    
  THAT THE STATEMENTS MADE IN THE FOREGOING ASSIGNMENT ARE TRUE
.	
DATED THIS	DAY OF	,20