The Hawaii T 4 form is an official document used for the assignment of a trade name, trademark, or service mark in the state of Hawaii. This form ensures that the rights to a trademark are properly transferred from one entity to another, safeguarding the interests of both the assignor and assignee. Completing this form accurately is crucial for maintaining legal protections for your business identity; please fill out the form by clicking the button below.
The Hawaii T 4 form plays a crucial role in the assignment of trade names, trademarks, or service marks within the state. This document is essential for anyone looking to transfer ownership of intellectual property rights, ensuring that both the assignor and assignee are legally recognized in the transaction. For a nominal nonrefundable filing fee of $10.00, individuals or entities can formalize their agreement, safeguarding their interests and facilitating the smooth transfer of rights. The form requires detailed information, including the names and addresses of both the assignor and assignee, as well as their respective statuses—whether they are sole proprietors, corporations, partnerships, or other types of entities. Additionally, it captures the specifics of the trade name, trademark, or service mark being assigned, including its certificate number and classification. Completing the form accurately is vital, as it must be signed by the assignor or an authorized representative, depending on the entity type. This process not only protects the rights of the parties involved but also helps maintain the integrity of the state's business registration system.
WWW.BUSINESSREGISTRATIONS.COM
STATE OF HAWAII
FORM T-4
Nonrefundable Filing Fee: $10.00
DEPARTMENT OF COMMERCE AND CONSUMER AFFAIRS
7/2010
Business Registration Division
335 Merchant Street
*T4*
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
Unincorporated Association
OR
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:
4.Status of Assignee (check only one):
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):
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
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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