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- Form T-4 "Assignment of Trade Name, Trademark or Service Mark" - Hawaii
Form T-4 "Assignment of Trade Name, Trademark or Service Mark" - Hawaii
What Is Form T-4?
This is a legal form that was released by the Hawaii Department of Commerce & Consumer Affairs - a government authority operating within Hawaii. As of today, no separate filing guidelines for the form are provided by the issuing department.
Form Details:
- Released on July 1, 2010;
- The latest edition provided by the Hawaii Department of Commerce & Consumer Affairs;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form T-4 by clicking the link below or browse more documents and templates provided by the Hawaii Department of Commerce & Consumer Affairs.
![Form T-4 "Assignment of Trade Name, Trademark or Service Mark" - Hawaii](https://data.templateroller.com/pdf_docs_html/22/223/22304/page_1_thumb.png "Form T-4 "Assignment of Trade Name, Trademark or Service Mark" - Hawaii")
1![Form T-4 "Assignment of Trade Name, Trademark or Service Mark" - Hawaii, Page 2](https://data.templateroller.com/pdf_docs_html/22/223/22304/page_2_thumb.png "Form T-4 "Assignment of Trade Name, Trademark or Service Mark" - Hawaii, Page 2")
2FORM T-4
B
R
WWW.
USINESS
EGISTRATIONS.COM
STATE OF HAWAII
Nonrefundable Filing Fee: $10.00
7/2010
DEPARTMENT OF COMMERCE AND CONSUMER AFFAIRS
Business Registration Division
*T4*
335 Merchant Street
Clear Form
Mailing Address: P.O. Box 40, Honolulu, Hawaii 96810
Phone No. (808) 586-2727
ASSIGNMENT OF TRADE NAME, TRADEMARK OR SERVICE MARK
(Chapter 482, Hawaii Revised Statutes)
PLEASE TYPE OR PRINT LEGIBLY IN BLACK INK
1.
Assignor's Name (Registrant):
Assignor's Address:
(including city, state, and zip code)
2.
Status of Assignor (check only one):
Sole Proprietor
Corporation
Partnership
LLC
LLP
OR
Unincorporated Association
Other (explain):
If assignor is an entity, list state or country of incorporation/formation/organization:
DOES HEREBY ASSIGN, SELL, TRANSFER, SET OVER, AND CONVEY (TOGETHER WITH ALL GOODWILL AND ALL RIGHTS TO SUE FOR PAST
INFRINGEMENT, IF ANY) TO:
3.
Assignee's Name:
Assignee's Address:
(including city, state, and zip code)
4.
Status of Assignee (check only one):
Sole Proprietor
Corporation
Partnership
LLC
LLP
OR
Other (explain):
Unincorporated Association
If assignee is an entity, list state or country of incorporation/formation/organization:
5.
(a) The trade name, trademark or service mark (line out inapplicable type) being assigned is:
(b) Certificate Number:
(c) Classification of trademark or service mark:
I certify, under the penalties set forth in Section 482-51, Hawaii Revised Statutes, that (check one):
OR
I am the assignor
I am the
of the assignor named in the foregoing application, I am authorized to sign this
(Office Held)
Assignment, and that the above statements are true and correct to the best of my knowledge and belief.
(
Print Name)
(
(Signature)
Date)
SEE INSTRUCTIONS ON REVERSE SIDE. Assignment must be signed by the assignor (registrant).
-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
(DEPARTMENTAL USE ONLY)
CERTIFICATE OF ASSIGNMENT
Certificate of Registration .
is hereby assigned to the above-named Assignee, effective
DEPARTMENT OF COMMERCE AND CONSUMER AFFAIRS
STATE OF HAWAII
Dated:
(Director of Commerce and Consumer Affairs)
B49 (Fee)
S18 (SH)
FORM T-4
B
R
WWW.
USINESS
EGISTRATIONS.COM
STATE OF HAWAII
Nonrefundable Filing Fee: $10.00
7/2010
DEPARTMENT OF COMMERCE AND CONSUMER AFFAIRS
Business Registration Division
*T4*
335 Merchant Street
Clear Form
Mailing Address: P.O. Box 40, Honolulu, Hawaii 96810
Phone No. (808) 586-2727
ASSIGNMENT OF TRADE NAME, TRADEMARK OR SERVICE MARK
(Chapter 482, Hawaii Revised Statutes)
PLEASE TYPE OR PRINT LEGIBLY IN BLACK INK
1.
Assignor's Name (Registrant):
Assignor's Address:
(including city, state, and zip code)
2.
Status of Assignor (check only one):
Sole Proprietor
Corporation
Partnership
LLC
LLP
OR
Unincorporated Association
Other (explain):
If assignor is an entity, list state or country of incorporation/formation/organization:
DOES HEREBY ASSIGN, SELL, TRANSFER, SET OVER, AND CONVEY (TOGETHER WITH ALL GOODWILL AND ALL RIGHTS TO SUE FOR PAST
INFRINGEMENT, IF ANY) TO:
3.
Assignee's Name:
Assignee's Address:
(including city, state, and zip code)
4.
Status of Assignee (check only one):
Sole Proprietor
Corporation
Partnership
LLC
LLP
OR
Other (explain):
Unincorporated Association
If assignee is an entity, list state or country of incorporation/formation/organization:
5.
(a) The trade name, trademark or service mark (line out inapplicable type) being assigned is:
(b) Certificate Number:
(c) Classification of trademark or service mark:
I certify, under the penalties set forth in Section 482-51, Hawaii Revised Statutes, that (check one):
OR
I am the assignor
I am the
of the assignor named in the foregoing application, I am authorized to sign this
(Office Held)
Assignment, and that the above statements are true and correct to the best of my knowledge and belief.
(
Print Name)
(
(Signature)
Date)
SEE INSTRUCTIONS ON REVERSE SIDE. Assignment must be signed by the assignor (registrant).
-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
(DEPARTMENTAL USE ONLY)
CERTIFICATE OF ASSIGNMENT
Certificate of Registration .
is hereby assigned to the above-named Assignee, effective
DEPARTMENT OF COMMERCE AND CONSUMER AFFAIRS
STATE OF HAWAII
Dated:
(Director of Commerce and Consumer Affairs)
B49 (Fee)
S18 (SH)
FORM T-4
7/2010
Instructions: Assignment must be typewritten or printed in black ink, and must be legible. Signature must be in black ink. Submit
assignment together with the appropriate fee.
Assignment must be signed by the assignor (registrant) only. For corporations, assignment must be signed by an authorized officer of the
corporation. For general or limited partnerships, assignment must be signed by a general partner. For LLC, assignment must be signed by
a manager of a manager-managed company or by a member of a member-managed company. For LLP, assignment must be signed by a
partner.
Line 1.
State the full name of the assignor (the current owner of the registration). State the complete address (including city, state, and zip
code) of the assignor.
Line 2.
Check one box to indicate the status of the assignor. If you check “Other,” you must explain what type of entity the assignor is.
If the assignor is a corporation, partnership, or limited liability company, list the state or country in which it was incorporated, formed
or organized.
Line 3.
State the full name of the assignee (the one to whom the registration is being assigned). State the complete address (including city,
state, and zip code) of the assignee.
Line 4.
Check one box to indicate the status of the assignee. If you check “Other,” you must explain what type of entity the assignee is.
If the assignee is a corporation, partnership, or limited liability company, list the state or country in which it was incorporated, formed
or organized.
Line 5.
(a) State the trade name, trademark or service mark to be assigned. If the mark being assigned includes a design, state the
complete description of the mark and submit a sample of the design which is being assigned.
(b) State the Certificate No. of the trade name, trademark or service mark being assigned.
(c)
State the classification of the trademark or service mark being assigned.
Filing Fees: Filing fee ($10.00) is not refundable. Make checks payable to DEPARTMENT OF COMMERCE AND
CONSUMER AFFAIRS. Dishonored Check Fee $25.00.
For any questions call (808) 586-2727. Neighbor islands may call the following numbers followed by 6-2727 and the # sign:
Kauai 274-3141; Maui 984-2400; Hawaii 974-4000, Lanai & Molokai 1-800-468-4644 (toll free).
Fax: (808) 586-2733
Email Address:
breg@dcca.hawaii.gov
NOTICE: THIS MATERIAL CAN BE MADE AVAILABLE FOR INDIVIDUALS WITH SPECIAL NEEDS. PLEASE CALL THE DIVISION
SECRETARY, BUSINESS REGISTRATION DIVISION, DCCA, AT 586-2744, TO SUBMIT YOUR REQUEST.
ALL BUSINESS REGISTRATION FILINGS ARE OPEN TO PUBLIC INSPECTION. (SECTION 92F-11, HRS)
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DA Form 2062 "Hand Receipt/Annex Number"
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DD Form 2813
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DD Form 2977 "Deliberate Risk Assessment Worksheet"
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AF Form 910 "Enlisted Performance Report (AB Thru Tsgt)"
-
DD Form 1750 "Packing List"
-
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-
DD Form 2923 "Privacy Act Data Cover Sheet"
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