Addendum For Renewal (United States)
This is a copyright form for an addendum for renewal of works. The form provided here is simply a sample of what the actual Addendum Form RE looks like.
ADDENDUM TO FORM RE
UNITED STATES COPYRIGHT OFFICE
RENEWAL REGISTRATION NUMBER __________________________
DO NOT WRITE ABOVE THIS LINE.
1 TITLE OF WORK IN WHICH RENEWAL IS CLAIMED:
2 NAME OF THE AUTHOR(S): __________________________
3 CITIZENSHIP AND/OR DOMICILE OF THE AUTHOR(S) AT THE TIME THE WORK WAS FIRST PUBLISHED:
4 DATE AND NATION OF FIRST PUBLICATION:
____________________ Month ________________ Day ________ Year
5 Manufacture: __________________________
A. If this is a nondramatic literary work or a two-dimensional print or label, the country in which the work was manufactured:
B. The processes by which the work was manufactured:
6 DEPOSIT: (Check one)
❑ A. One complete copy of this work as first published is deposited with this application.
❑ B. A complete copy of this work as first published cannot be deposited for the following reason:
7 VERIFICATION OF NOTICE:
I hereby aver that all copies of this work as first published bore the copyright notice as it appears in the accompanying deposit materials and said copyright notice appeared on all copies of the work published in the United States until December 31, 1977.
Signature of applicant: __________________________
I certify under penalty of perjury under the laws of the United States of America that the foregoing is true and correct.
Signature of applicant: __________________________
Date signed: __________________________
Daytime telephone number: __________________________
FAX number if any: __________________________
Email address: __________________________
DO NOT WRITE HERE OFFICE USE ONLY
ADDENDUM RECEIVED __________________________
DEPOSIT RECEIVED __________________________
When to Complete the Addendum: The Addendum to Form RE must be completed when registration of the work for which renewal registration is sought was not completed during the first 28-year term of copyright. If registration was made during the first term of copyright, complete space 4 of the Form RE instead.
Fee: As of July 1, 1999, the nonrefundable filing fee for the addendum to Form RE is $15. This fee is in addition to the $45 fee for Form RE, which must accompany the addendum.
PRIVACY ACT ADVISORY STATEMENT
Required by the Privacy Act of 1974 (Public Law 93-579)
AUTHORITY FOR REQUESTING THIS INFORMATION:
• Title 17, U.S.C., Sec. 304
FURNISHING THE REQUESTED INFORMATION IS:
BUT IF THE INFORMATION IS NOT FURNISHED:
• It may be necessary to delay or refuse renewal registration
• If renewal registration is not made before expiration of the original copyright term, ownership of the renewal term may be affected
PRINCIPAL USES OF REQUESTED INFORMATION:
• Establishment and maintenance of a public record
• Examination of the application for compliance with registration requirements of the copyright code
OTHER ROUTINE USES:
• Public inspection and copying
• Preparation of public indexes
• Preparation of public catalogs of copyright registrations
• Preparation of search reports upon request
• No other advisory statement will be given you in connection with this application
• Please keep this statement and refer to it if we contact you regarding this application
INSTRUCTIONS FOR FILLING IN THIS FORM
SPACE 1: Title of the Work
Give the title as of the time of first publication.
SPACE 2: Name of the Author(s)
Name at least one author of the work.
SPACE 3: Citizenship and/or Domicile of the Author(s)
Give the nation of citizenship and/or domicile for at least one author of the work at the time the work was first published.
SPACE 4: Date and Nation of First Publication
Give the exact date of publication in this space. If the exact date is not known and must be estimated, it is still necessary to enter a month, day, and year. The earliest possible date should be used. Also, give the nation where the work was first published.
SPACE 5: Manufacture
This space must be completed if the work is a nondramatic literary work with or without accompanying illustrations. In part A, identify the nation(s) where the mechanical processes in the manufacture of the work--typesetting, printing, and binding--were done. In part B, describe the processes by which the work was manufactured. This space also applies to certain two-dimensional prints.
SPACE 6: Deposit
If copies of the work as first published are available, you must send one such copy along with your application and fee. Check Box A in this case. Check Box B if no copy can be procured to send with the application and fee; explain fully why you are unable to obtain a copy. You will be contacted by the Renewals Section to determine a suitable deposit.
SPACE 7: Verification of Notice
The statement in this space requires the handwritten signature of the applicant and constitutes an affidavit of publication with notice.
SPACE 8: Certification
This space also requires the handwritten signature of the applicant, along with the date of signing. Providing the Copyright Office with a daytime telephone number, email address, and FAX number, if any, will facilitate resolution of any problems or questions concerning your application for renewal registration.
Why Does the Copyright Office Need the Information Requested in This Addendum?
Works published prior to January 1, 1978, were subject to the 1909 copyright law. This law was stricter than the law currently in effect. Certain formalities had to be met in order for a work of authorship to secure copyright protection. The use of a copyright notice in a prescribed form and location was required. For most works, the notice had to include the word "Copyright," its abbreviation "Copr.," or the symbol "©;" the name of the copyright owner; and the date of first publication. Eligibility had to be established for both published and unpublished works based on the citizenship or domicile of the author(s) or the nation where the work was first published. Certain literary and artistic works had to be manufactured in the United States in order to qualify for full-term copyright protection in this country. The information appearing in this form will determine whether the work is currently under copyright protection in the United States. If the work is in the public domain in this country, having failed to meet one or more of the preceding requirements, renewal registration will be denied.