Trade and Service Marks--Assignment or Cancellation (Oregon)
This is to assign or cancel a registration for trademark and service mark in Oregon. The form provided here is simply a sample of what the actual Form CR172 looks like.
CR172
Phone: (503) 986-2200
Fax: (503) 378-4381
Secretary of State
Corporation Division
255 Capitol St. NE, Suite 151
Salem, OR 97310-1327
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For office use only
Registry Number: ________________________________
Attach Additional Sheet if Necessary
Please Type or Print Legibly in Black Ink
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Trade and Service Marks--Assignment or Cancellation
1) Correspondent Name And Mailing Address
Address _______________________________
City _______________________________
State _______________________________
Zip _______________________________
2) Applicant's Name And Address (Owner)
Address _______________________________
City _______________________________
State _______________________________
Zip _______________________________
3) Date Mark Was Originally Filed _______________________________
4) Description Of Trade Or Service Mark
_______________________________
_______________________________
ASSIGNMENT ONLY
5) Class Number(s) for Which Mark Was Registered
_______________________________
6) Name and Business Address of Assignee
Name _______________________________
Street Address _______________________________
City _______________________________
State _______________________________
Zip _______________________________
7) If the Assignor is a Corporation, Enter the State of Incorporation.
_______________________________
_______________________________
8) If the Assignee is a Corporation, Enter the State of Incorporation.
_______________________________
9) Execution
Now, therefore, for good and valuable consideration, receipt of which is hereby acknowledged, ASSIGNOR does hereby assign onto the ASSIGNEE all right, title, and interest in and to the mark, together with the good will of the business in which the mark is used (or that part of the good will of the business connected with the use of an symbolized by the mark), and the registration thereof.
Assignor Signature: _______________________________
Title: _______________________________
Date: _______________________________
CANCELLATION ONLY
10) Registry Number _______________________________
11) Execution
Signature: _______________________________
Date: _______________________________
12) Contact Name _______________________________
Daytime Phone Number - Including Area Code ___________________
FEES
Make check for $10 payable to "Corporation Division." Registration is good for five years from the date of registration.