(1) A registrant that has effected a change of name or change of address may file an amendment changing its name and/or address. The amendment consists of a form supplied by the Division or a document formatted in the same manner as the Division form. The amendment shall contain:

1. (a) the applicant’s name and business address;
2. (b) a written description of the mark;
3. (c) for each class, the number and class in which the goods or services fall;
4. (d) the registration date and number; and
5. (e) the registrant’s new name; and/or
6. (f) new business address.