Free Form D-VH/CON - Federal

3 Form D-VH / CON
For Vessel Hull Design
UNITED STATES COPYRIGHT OFFICE REGISTRATION NUMBER DAT E O F R E GI S T R AT I O N /P UBLI C AT I ON

C O N T I N UAT I O N S HE E T R E C E I VE D

DO NOT WRITE ABOVE THIS LINE. FOR COPYRIGHT OFFICE USE ONLY.

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Check here, if using for multiple designs: Fill in Space A ONLY with new information regarding additional designs. All other information must be identical to the information on the corresponding Form D-VH. Use an additional Form D-VH/CON for each design included in the registration. Design __ of __ designs.

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Check here, if you are using the continuation sheet for supplemental information regarding the original design.

Identification of Application

IDENTIFICATION OF CONTINUATION SHEET: This is a continuation of the application for copyright registration on Form D-VH. Identify the title of the work as it appears in Space 1 (i.e., make and model of the vessel) of Form D-VH: .........................................................................................................

A

(2a) What is the type or style of the design for which registration is sought?

Continuation of Space 2

(2b) Provide a brief general statement setting forth the salient features of the design.

(2c)

If this design is derived from an earlier design, explain how that design has been revised, adapted, or rearranged.

17 USC §1327. Penalty for false representation. "Whoever knowingly makes a false representation materially affecting the rights obtainable under this chapter for the purpose of obtaining registration of a design under this chapter shall pay a penalty of not less than $500 and not more than $1,000, and any rights or privileges that individual may have in the design under this chapter shall be forfeited."

Continuation of (check which):

ò Space 3 ò Space 4 ò Space 5

ò Space __

B
Continuation of Spaces Other than Space 2

MAIL TO Certificate will be mailed in window envelope

Name

Number/Street/Apt

City/State/Zip

YOU MUST: Complete all necessary spaces SEND ALL ELEMENTS IN THE SAME PACKAGE: 1 Application form 2 Nonrefundable filing fee in check or money order payable to Register of Copyrights MAIL TO: Dept D-VH Vessel Hull Registration PO Box 71380 Washington, DC 20024-1380

C

Address for return of certificate

form dvh/con

rev: 07/2006

print: 07/2006

Printed on recycled paper

U.S. Government Printing Office: 2006-xxx-xxx / xx,xxx