COVER LETTER
TO: Registration Section Division of Corporations
SUBJECT:______________________________________________________________ (Name of Mark to be cancelled) The enclosed Application for the Cancellation of a Trademark and/or Service Mark 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: $50.00 Filing Fee STREET ADDRESS: Registration Section Division of Corporations Clifton Building 2661 Executive Center Circle Tallahassee, FL 32301
CR2E077 (1/07)
$102.50 Filing Fee and Certified Copy MAILING ADDRESS: Registration Section Division of Corporations P. O. Box 6327 Tallahassee, FL 32314
APPLICATION FOR THE CANCELLATION OF A TRADEMARK AND/OR SERVICE MARK Pursuant to s. 495.101, Florida Statutes, the undersigned hereby submit(s) this application to cancel the following trademark and/or service mark registration: 1. Mark to be cancelled: ___________________________________________________ 2. Registration Number: ___________________________________________________ 3. Date of Registration: ____________________________________________________ 4. Signature of Owner(s): ___________________________________
Owner's Signature
___________________________________
Co-Owner's Signature, if any
___________________________________ ___________________________________ Typed or Printed Name of Owner
____________________________________ ____________________________________ Typed or Printed Name of Co-Owner
Typed or Printed Name of Person Signing Above Typed or Printed Name of Person Signing Above
STATE OF ____________________________ COUNTY OF __________________________ On this _____ day of _______________, 20_____, , [Enter Name(s) of Person(s) Signing Above] personally appeared before me, who is/are personally known to me or whose . ____________________________________ Notary Public's Signature (Seal) ____________________________________ Notary Public's Printed Name
identity (ies) I proved on the basis of
My Commission Expires: ______________________ (Attach additional sheet if necessary) Filing Fee: Certified Copy (optional): $50.00 $52.50