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 or 1-877-476-0778 (toll free).
Mail to:
Dept. D
-
VH
Vessel Hull Registration
P O Box 71380
Washington, DC 20024-1380
5
Form D
-
VH
-
ID
For Recordation of Distinctive Identification of Owner of Vessel Hull Design
United States Copyright Office
form d-vh-id reviewed: 09
2012 Printed on recycled paper u.s. government printing office: 2012-xxx-xxx ⁄xx,xxx