COVER LETTER
TO: Registration Section
Division of Corporations
SUBJECT:
(Name of Mark)
The enclosed Certificate of Change of Name of the Registrant or Applicant of a Florida Trademark and/or
Service Mark Registration and fee(s) are submitted for filing.
Please return all correspondence concerning this matter to:
(Contact Person)
(Firm/Company)
(Address)
(City, State and Zip Code)
For further information concerning this matter, please call:
at ( )
(Name of Contact Person) (Area Code and Daytime Telephone Number)
Enclosed is a check for the following amount:
$50 Filing Fee and Certificate of $102.50 Filing Fee, Certified Copy,
Registration (Free of Charge) and Certificate of Registration (Free
of Charge)
Mailing Address: Street Address:
Registration Section Registration Section
Division of Corporations Division of Corporations
P.O. Box 6327 The Centre of Tallahassee
Tallahassee, FL 32314 2415 N. Monroe Street, Suite 810
Tallahassee, FL 32303
CR2E121 (1/07)
CERTIFICATE OF CHANGE OF NAME
OF THE REGISTRANT OR APPLICANT OF A
FLORIDA TRADEMARK AND/OR SERVICE MARK REGISTRATION
Pursuant to s. 495.081(3), Florida Statutes, the undersigned hereby submits this certificate to change the name
of the registrant or applicant of the following Florida trademark and/or service mark registration:
1. Name of Mark:
2. Registration Number:
3. Date of Registration:
4. a. Name of owner as it appears on the trademark/service mark registration:
b. Address of owner as it appears on the trademark/service mark registration:
5. a. New name of owner:
b. New mailing address, if applicable:
SIGNATURE:
Owner’s Signature:
Typed/Printed Name of Person Signing:
STATE OF
COUNTY OF
On this day of , 20 .
(Enter Name of Person Signing Above)
Personally appeared before me, who is personally known to me or whose identity I
proved on the basis of .
(Seal)
Notary Public’s Signature
Notary Public’s Printed Name
My Commission Expires:
(Attach additional sheet if necessary)
Filing fee: $50.00
Certificate of Registration: Issued Free of Charge
Certified Copy (optional): $52.50