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Fill and Sign the Wyoming Secretary of States Office Efiling Refund Form

Fill and Sign the Wyoming Secretary of States Office Efiling Refund Form

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For Office Use Only Ed Murray Wyoming Secretary of State 2020 Carey Avenue, Suite 700 Cheyenne, W Y 82002-0020 Ph. 307. 777.7311 Fax 307.777.5339 Email: Business@wyo.gov TN -Assignment - Revised October 2015 Assignment of Trade Name Registration 1. I, (N ame of assignor) At the addres s of : 2. Has adopted, used and is using the trade name: 3. T rade name is registered with the Secretary of State, Registration Number is: 4. I hereby assign said trade name and registration thereof to: (Name of assignee) At the address of: Assignor Signature: ___________________________________________ Date: (mm/dd/yyyy) Print Name: Contact Person: Title: Daytime Phone Number: Email: (Email provided will receive filing evidence) *May list multiple email addresses Checklist Filing Fee: $25.00 Make check or money order payable to Wyoming Secretary of State. Please submit one originall y signed document. Typical processing time is 3 -5 business days following the date of receipt in our office. Please review form prior to submitting to the Secretary of State to ensure all areas have been completed to avoid a delay in the processing of your documents.

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