The owner named below is an owner of one or more vessel hull designs pursuant to the Vessel Hull Design Protection Act and is entitled to use the following distinctive identification in design notices placed on vessels for which design protection is claimed:
Place the words or symbols constituting the distinctive identification in the space above.
Name of owner of design Address
Signature of person submitting designation Date Name of person submitting designation Relationship to owner note: This form must be accompanied by a filing fee made payable to Register of Copyrights. Copyright Office fees are subject to change. For current fees, check the Copyright Office website at www.copyright.gov , write the Copyright Office, or call (202) 707-3000. Mail to: Dept. D-VH Vessel Hull Registration P O Box 71380 Washington, DC 20024-1380
rev: 05 / 2007
print: 05 / 2007 -- xx,000
Printed on recycled paper
u.s. government printing office: 2007-330-945 /60,xxx