For Restored Works (United States)
This is a copyright form for restored works. The form provided here is simply a sample of what the actual Form GATT/GRP looks like.
FORM GATT/GRP
For Restored Works
UNITED STATES COPYRIGHT OFFICE
TX ____ PA ____ VA ____ SR ____ SRU
Registration Number ___________________________
Month ___________________________
Day ___________________________
Year ___________________________
DO NOT WRITE ABOVE THIS LINE. IF YOU NEED MORE SPACE, USE A SEPARATE CONTINUATION SHEET.
1a TITLES
1. Title ___________________________
English translation ___________________________
2. Title ___________________________
English translation ___________________________
3. Title ___________________________
English translation ___________________________
4. Title ___________________________
English translation ___________________________
1b DESCRIPTION OF THE WORKS: (Check one or more)
____ literary work
____ musical work, including any accompanying words
____ dramatic work, including any accompanying music
____ pantomime or choreographic work
____ pictorial, graphic, or sculptural work
____ motion picture or other audio/visual work
____ architectural work
____ sound recording, created in ___________________________
2 AUTHOR(S):
a Name ___________________________
Citizenship (when work was created): ___________________________
Domicile (when work was created): ___________________________
Date of death: ___________________________
b Name: ___________________________
Citizenship (when work was created): ___________________________
Domicile (when work was created): ___________________________
Date of death: ___________________________
3 YEAR AND NATION OF PUBLICATION:
(If the works were published, give the year and nation in which they were first published.)
Year: ___________________________
Nation: ___________________________
DO NOT WRITE HERE. OFFICE USE ONLY.
APPLICATION RECEIVED ___________________________
DEPOSIT RECEIVED ___________________________
FUNDS RECEIVED _____________________
4a OWNER(S) OF U.S. COPYRIGHT:
Name: ___________________________
Address: ___________________________
___________________________
4b Means by which copyright ownership was transferred (if owner is not the author):
___________________________
5 LIMITATION OF COPYRIGHT: If, for any work in the group the registration does not extend to the entire work, give the title and describe the material that is covered by the registration (see instructions):
___________________________
6 PREVIOUS REGISTRATION: If any of the works were ever registered in the U.S. Copyright Office, give the title, registration number, and year if known:
___________________________
7 DEPOSIT ACCOUNT If the registration fee is to be charged to a deposit account established in the Copyright Office, give the name and number of that account. Do not give credit card information on this form.
Name ___________________________
Account Number ___________________________
CORRESPONDENCE Give the name and address to which correspondence about this application should be sent.
____ Same as space 4a.
____ Same as space 9.
Area or Country Code and Telephone Number ____________________
Fax Number ___________________________
Email ___________________________
8 CERTIFICATION* I, the undersigned, hereby certify that I am the: (Check one)
____ Author
____ Owner of U.S. copyright
____ Agent of ___________________________ (Name of author or owner of U.S. copyright) of the works identified in this application and that the statements made by me in this application are correct to the best of my knowledge.
Typed or printed name: ___________________________
Data: ___________________________
Handwritten signature ___________________________
Address
Name ___________________________
Number/Street/Apt ___________________________
City/State/ZIP/Nation ___________________________
9 YOU MUST:
• Complete all necessary spaces
SEND ALL ELEMENTS IN THE SAME PACKAGE:
1. Application form
2. Nonrefundable filing fee in check or money order payable to Register of Copyrights
MAIL TO
Dept D-VH
Vessel Hull Registration
P.O. Box 71380
Washington, D.C. 20024-1380