Free Cancellation of a Trademark - Arizona

Office Use Please mail Registration to: Secretary of State Ken Bennett / Trade Name Division 1700 West Washington 7th Fl. Phoenix, Arizona 85007 Walk-in service: 14 N. 18th Ave., Phoenix, Arizona Tucson Office: 400 W. Congress, Ste. 252 (602) 542-6187 (800) 458-5842 (within Arizona) Filing Fee: None

CANCELLATION TRADENAME TRADEMARK File Number: Trade Name or Trademark Description:

The individual, partner or officer, if a corporation or LLC, must sign and date the cancellation of the trade name or trademark. APPLICANT'S PRINTED NAME ______________________________ APPLICANT'S PRINTED NAME State of Arizona County of _________ _ APPLICANT'S SIGNATURE APPLICANT'S SIGNATURE

On this ______ day of _____________________, 20___, before me personally appeared __________________________________, (name(s) of signer(s)) whose identity was proved to me on the basis of satisfactory evidence to be the person whose name is subscribed to this document, and who acknowledge that he/she signed the above document. __________________________ Notary Public