Trademark Assignment

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Name*
User's full name
Email*
Phone Number*
Please enter a number from 0 to 11.
Section 1/5: Parties
ASSIGNOR (i.e the person or corporate body that owns the trademark).
1. The assignor is an;*
- i. Individual
- Corporate body
2. How many assignors are included in this Agreement?
3. Please provide the following;
Name of assignor 1*
First Middle Last
Address of assignor 1*
Name of assignor 2
First Middle Last
Address of assignor 2
NB; If the Assignor is more than one, please provide the details of the others in the format provided in (2) above.
ASSIGNEE (i.e the person or corporate body who receives the assigned rights)..
4. The assignee is an;*
- iii. Individual
- iv. Corporate body
5. How many assignors are included in this Agreement?*
6. Please provide the following;
Name of assignee 1*
First Middle Last
Address of assignee 1*
Name of assignee 2
First Middle Last
Address of assignee 2
NB; If the Assignor is more than one, please provide the details of the others in the format provided in (2) above.

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Section 2/5: Nature of Trademark
7. Are you transferring a trademark or a service mark?*
- Trademark
- Service mark
8. The mark a;*
- i. Word or a phrase
- ii. Design or symbol
9. Please set out the word, phrase, design, or symbol as it is used in your business.
10. The mark is;*
- i. Registered.
- ii. Not Registered.
- iii. Pending Registration.
11. Where is the mark registered? ( If registered)*
State*

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Section 3/5: Price / Consideration
12. How much will be paid as consideration for the agreement.*
13. When will the price be paid?*
- i. On execution of this agreement.
- ii. Specified date.
- iii. Other.

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Section 4/5: Representations and Warranties
14. Please select the representations that the Assignee will make.*
- i. The assignor owns the trademark.
- ii. The mark is free of all security interests.
- iii. The assignor has not granted any licenses to use the mark.
- iii. The assignor has not granted any licenses to use the mark.

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Section 5/5: Signing Details
15. Name of the Assignor or person acting on behalf of the Assignor.
First Middle Last
16. Designation of the Assignor or person acting on behalf of the Assignor.
17. Name of Assignee or person acting on behalf of Assignee.
First Middle Last

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