Fillable US Copyright Office - Form DC

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US Copyright Office - Form DC

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The US Copyright Office - Form DC form is 2 pages long and contains:

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  • 2 check-boxes
  • 35 other fields

Country of origin: US
File type: PDF

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do not write above this line.
A
make and model of the vessel that embodies the design
Registration number of the basic registration
Year of basic registration
Name(s) of designer(s)
Name(s) of owner(s) (
if dierent than designer
(
s
) )
B
location and nature of incorrect information
Please provide the location and nature of the clerical or typographical error, and set forth the incorrect information as it
appears in the basic registration and the corrected information.
Space number
Space heading or description
Incorrect information as it appears: Corrected information:
Explanation of correction(s)
C
correspondence
Give name and address to which correspondence about this application should be sent.
Name
Address
Phone
( )
Fax
( ) Email
D
deposit account
If the registration fee is to be charged to a deposit account established in the Copyright Oce, give name and number
of account.
Name
Account number
5
Form DC
To Correct a Design Registration
united states copyright office
registration number
U. S. Copyright Oce · Library of Congress · 101 Independence Avenue SE · Washington, DC 20559 · www.copyright.gov
  : 05/2019 Printed on recycled paper . .   : 2019-xxx-xxx ⁄ xx,xxx
do not write above this line.
E
certification
*
I, the undersigned, hereby certify that I am the (
check only one
)
owner of the registered design
duly authorized agent of , the owner of the registered design,
and that the statements made by me in this application are correct to the best of my knowledge.
    

F
mailing information
Certicate will be mailed in window envelope to this address:

 ⁄  ⁄ 
 ⁄  ⁄ 
you must:
• Complete all necessary spaces
• Sign your application in space E
send all elements in the same package:
1 Application form
2 Nonrefundable ling fee in check or money order payable to
U.S. Copyright Oce
mail to:
Library of Congress
Copyright Oce-VH
101 Independence Avenue SE
Washington, DC 20559-6000
* 17 USC §1327. Penalty for false representation.
“Whoever knowingly makes a false representation materially aecting 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.”
form dc received
funds received date
examined by
correspondence
Yes
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US Copyright Office - Form DC

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Completed 26 May 2020

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