DO NOT WRITE ABOVE THIS LINE. IF YOU NEED MORE SPACE, USE A SEPARATE CONTINUATION SHEET (FORM D-VH/CON).
MORE ON BACK
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Page 1 of pages
• Complete all applicable spaces (numbers 7–9) on the reverse side of this page.
• See detailed instructions. • Sign the form at space 9.
Give the make and model of the vessel that embodies the design.
a: What is the type or style of the design for which registration is sought?
b: Provide a brief general statement setting forth the salient features of the design.
c: If this design is derived from an earlier design, describe how that design has been revised, adapted, or rearranged.
Provide the name and address of the designer(s). The name of the employer may be given instead of the designer(s) if (1) the design
was made within the regular scope of employment of the designer(s) and (2) the individual authorship of the design is difficult or
impossible to ascribe.
Please check here if those conditions are satisfied and you are providing the employer’s name.
Name: Name:
Address: Address:
If the owner is different from the designer(s) or employer named above, provide the name and address of the owner:
Name:
Address:
a: Was an application for registration of this design identified
in an application filed in a foreign country that extends to
designs of owners who are citizens of the United States, or
to persons filing applications in the United States, similar
protection to that afforded in 17 USC chapter 13?
Yes No
Was this design made public before the date of application? Yes No
If yes, on what date?
Month Day Year
b: If yes, identify the country and date of application:
Country:
Date of application:
Serial no:
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OFFICE USE ONLY
application received
design copies received
funds received
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).
Form D-VH
3
For Vessel Hull Design
UNITED STATES COPYRIGHT OFFICE
registration number
date of registration/publication
month day year
1
title
2
designer(s)
Check here if this
is a single design.
Check here if
registering more
than one design.
Use Form D-VH/
CON for additional
designs.
3
designer(s)
4
owner,
if not
designer(s)
5
priority
claim
6
date made
public
Privacy Act Notice: Sections 408-410 of title 17 of the United States Code
authorize the Copyright Office to collect the personally identifying informa-
tion requested on this form in order to process the application for copyright
registration. By providing this information you are agreeing to routine uses
of the information that include publication to give legal notice of your copy-
right claim as required by 17 U.S.C. §705. It will appear in the Office’s online
catalog. If you do not provide the information requested, registration may
be refused or delayed, and you may not be entitled to certain relief, remedies,
and benefits under the copyright law.
