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What is the format of the trademark license contract registration form?

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Trademark License Contract Filing Form

Trademark Office of the State Administration for Industry and Commerce:

Trademark No. 1 registered by the factory (company) (photocopy of trademark registration/ A copy is attached), and according to Article 26 of the Trademark Law, the factory (company) is allowed to use it. After mutual agreement, a trademark license contract is signed, please file it.

Permitted trademarks: (affixed with trademark pattern, and stamped by the registrant)

Permitted goods:

Licensed period of use;

Permitted use period;

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For specific license conditions, please see the attached license contract.

Licensor: (Chapter) Licensee: (Chapter)

Address: Address:

Year, Month, Day

Attachment: