Author’s Claim Worksheet Form
Use this form to document and submit a claim related to your authorship, rights, attribution, or ownership dispute regarding a creative work.
Your Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Title of the Work
*
Type of Work
*
Please Select
Book
Article
Poem
Manuscript
Screenplay
Other
Date of Creation (if known)
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Nature of Your Claim
*
Authorship dispute
Rights dispute
Attribution issue
Ownership dispute
Other
Describe Your Claim or Dispute
*
List Any Other Parties Involved (if applicable)
Upload Supporting Documentation (optional)
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Preferred Method of Contact
Please Select
Email
Phone
Submit Claim
Should be Empty: