This agreement entered this (day) of (month), (year)
between (name of assignor) , of (address), City of (city)
State of (state) , herein referred to as “Assignor”, and
(name of assignee) of (address), City of (city), State of
(state) , herein referred to as “Assignee”.

That Assignor has adopted and is using a mark registered
in the United States Patent Office, Registration No.
(number), dated (date) and Assignee is desirous of
acquiring such mark and the registration thereof.

That for good and valuable consideration, the receipt of
which is hereby acknowledged, Assignor does hereby assign
to Assignee all rights, title and interest in and to said
mark, the goodwill of the business symbolized by said mark,
along with the registration thereof, the number of which
is contained herein.

Date____________________
________________________
(Signature)

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