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For Mask Works (United States)

This is a copyright form for mask works (MW) continuation. The form provided here is simply a sample of what the actual Form MW/CON looks like.

FORM MW/CON
For Mask Works

UNITED STATES COPYRIGHT OFFICE

REGISTRATION NUMBER MW ___________________________

EFFECTIVE DATE OF REGISTRATION

__________________ Month ____________________ Day ________ Year

CONTINUATION SHEET RECEIVED

Page ________ of ________ pages

CONTINUATION SHEET FOR FORM MW

• This sheet should be used to complete information appearing on Form MW.

• Identify the work by completing the first section.

• Spaces are provided to identify two additional owners.

• Other information may be provided in the last space.

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

IDENTIFICATION OF CONTINUATION SHEET: This sheet is a continuation of the application for registration on Form MW filed for the following work:

•TITLE: Give the title as given under the heading "Title of This Work" in space 1 of Form MW.

•NAME AND ADDRESS OF CURRENT OWNER(S): Give the name and address of at least one of the owners named at space 3 of Form MW.

NAME AND ADDRESS OF CURRENT OWNER(S)

___________________________

___________________________

CITIZENSHIP OR DOMICILE OF CURRENT OWNER(S)

Citizen of: ___________________________
or
Domiciled in: ___________________________

DERIVATION OF OWNERSHIP: If the person who created the mask work which is subject matter of this application is NOT named as the owner, check one: (Note: If a company or organization is named as the current owner, one of the following boxes must be checked.)

____ a. The owner is the employer of a person who created such mask work within the scope of his/her employment.

____ b. The owner has acquired the rights by transfer from the creator, employer or representative.

____ c. The owner is the legal representative of the deceased or legally incapacitated creator.

NAME AND ADDRESS OF CURRENT OWNER(S)

___________________________

___________________________

CITIZENSHIP OR DOMICILE OF CURRENT OWNER(S)

Citizen of: ___________________________
or
Domiciled in: ___________________________

DERIVATION OF OWNERSHIP: If the person who created the mask work which is subject matter of this application is NOT named as the owner, check one: (Note: If a company or organization is named as the current owner, one of the following boxes must be checked.)

____ a. The owner is the employer of a person who created such mask work within the scope of his/her employment.

____ b. The owner has acquired the rights by transfer from the creator, employer or representative.

____ c. The owner is the legal representative of the deceased or legally incapacitated creator.

ADDITIONAL INFORMATION: Indicate the Heading and the Space Number from the basic Form MW being amplified, followed by the added facts.

___________________________

___________________________

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