• Copyright Registration Form

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  • Date Issued
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  • Is the work previously registered or has been applied for registration?
  • Purpose for registration
  • Date of Birth
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  • Deceased
  • Date of Death
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    2 digit month, 2 digit day, 4 digit year
  • Is this a work made for hire?
  • Nature of Authorship
  • Date Created
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    2 digit month, 2 digit day, 4 digit year
  • Date First Published
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    2 digit month, 2 digit day, 4 digit year
  • Copyright Claimants

  • I hereby certify that the information in this appication and the statements made herein are true and correct to the best of my knowledge.

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