Non-Refundable Processing Fee: $15.00 Entity File Number: _________________________
Trademark Name: _
__________________________________________________________________________________________
For each Yes button that you mark the questio
n will appear below for you to fill out.
1). Do you want to Change the Address of the
Trademark’s Principal(s)? Yes No
1). If Yes, who is the Principal(s) whose Address you wish to Change?
You can not change the principal(s) on Trademarks, only the address of the principal(s). If you wish to change the principal(s) you will need to file
an Assignment of Utah Trademark. You may find that form on our website at: http://www.corporations.utah.gov/pdfforms/assigtmk.pdf
Name: ___________________________________________________ Position: ______________________________________
Address: __________________________________________________________ City ___________________ State ______ Zip __________
Name: ___________________________________________________ Position: ______________________________________
Address: __________________________________________________________ City ___________________ State ______ Zip __________
Name: ___________________________________________________ Position: ______________________________________
Address: __________________________________________________________ City ___________________ State ______ Zip __________
2a) Do you
want to add a class, replace a class, or change the class of good or service associated with the mark? Yes No
Please understand that the class codes you can add are limited, and the limitations are posted at http://www.corporations.utah.gov/goods_services.html.
What is the class code you want to change to? _____________________________________________________________________________
Are there additional class codes you would like to add t
o the trademark? Yes No
There is an additional $25 fee for each class you add to the trademark.
What is the class code you want to add? _____________________________________________________________________________
What is the class code you want to add? _____________________________________________________________________________
What is the class code you want to add? _____________________________________________________________________________
2b) Class codes dictated by §70-3a-308, wh
ich can be found here: http://le.utah.gov/~code/TITLE70/htm/70_03a030800.htm
3) Do you want to add the date of 1
st
use outside of Utah? Yes No
Please be aware that adding the date of first use outside of UT does not register their mark in which ever State other than UT it was used in,
nor can the date precede the date of first use in UT, which unless otherwise specified at the initial registration, is the date the application was
received.
Date of 1
st
use: ________________________________
4a) Do you want to add the information that is from the trademark being federally filed? Yes No
Filing Date: ________________________ Serial Number: ______________________
Current Status of the mark: ______________________________
4b) Has the mark been refused or has otherwise not resulted in a registration? Yes No
If Yes, list the reason:
_______________________________________________________________________________________________
Under
GRAMA {63G-2-201}, all registration information maintained by the Division is classified as public record. For confidentiality purposes, you
may use the business entity physical address rather than the residential or private address of any individual affiliated with the entity.
Under penalties of perjury and as an authorized authority, I declare that this statement of change(s), has been examined by me and is, to the
best of my knowledge and belief, true, correct and complete.
BY: ___________________________________ Signature of Authorizing Party: ______________________________
Title: __________________________________ Date: _________________________
State of Utah
Department of Commerce
Division of Corporations & Commercial Code
Trademark Registration Information Change Form
This form cannot be hand written.
Sign here after printing form
Mailing/Faxing Information:
www.corporations.utah.gov/contactus.html
www.corporations.utah.gov
