EXTRACT FROM THE
COPYRIGHT RULES, 1958, AS AMENDED
(See Rule 16)
Form IV – Application
for Registration of Copyright
To
The Registrar of
Copyrights
Copyright Office
New Delhi : 110001.
Sir,
In
accordance with Section 45 of the Copyright Act, 1957 (14 of 1957), I hereby
apply for
registration
of Copyright and request you that entries may be made in the Register of Copyrights
in the enclosed Statement of Particulars sent herewith in triplicate.
I
also send herewith duly completed Statement of further Particulars relating to
the work. (for Literary, Dramatic, Musical and Artistic works only)
2. In accordance with Rule 16 of
the Copyright Rules, 1958, I have sent by prepaid registration post copies of
this letter and of the enclosed Statement(s) to the other parties concerned, as
shown below:
______________________________________
Name and address of
the parties
Date of dispatch
(1) (2)
_____________________________________
[See columns 7, 11,12 and 13 of the Statement
of Particulars and the party referred in Col.2(e) of the Statement of Further
Particulars.]
3. The prescribed fee has been paid, as
per details below:
4. Communications on this subject may
be addressed to:
5. I hereby declare that to the best of
my knowledge and belief, no person, other than to whom a notice has been sent
to as per paragraph 2 above any claim or interest or dispute to my copyright of
this work or to its use by me.
6. I hereby verify that the particulars
given in this Form and in the Statement of Particulars and Statement of Further
Particulars are true to the best of my knowledge, belief and information and
nothing has been concealed there from.
Yours faithfully,
Signature of the
applicant
List of enclosures:
Place:
Date:
Statement
of Particulars
(to
be send in triplicate)
1. Registration No. (to
be filled in by the Copyright Office)
2. Name, address &
nationality of the Applicant:
3. Nature of the
Applicant’s interest in the
Copyright of the
work:
4. Class and description
of the work:
5. Title of the work:
6. Language of the work:
7. Name, address &
Nationality of the Author and
if the author is
deceased, the date of decease:
8. Whether the work is
published or unpublished:
9. Year and Country of
first publication
Name, address and
nationality of the publisher:
10. Years and countries
of subsequent publications
if any and names,
addresses and nationalities of
the publishers:
11. Names, addresses and
nationalities of the owners
of various rights
comprising the copyright in the work
and the extent of
rights held by each, together with
the particulars of
assignments and licence, if any:
12. Names, addresses and
nationalities of other persons,
if any authorized to
assign or licence the rights
comprising the
copyrights:
13. If the work is
‘Artistic’ the location of the original work
including name and
address and nationality of the
person in possession
of the work, (in case of an
architectural work,
the year of completion of the
work should also be
shown).
13.A. If the work is an
Artistic work which is used or is
capable of being used
in relation to any goods, the
application should be
include a certification from the
Registrar of Trade
Marks in terms of the proviso to
Sub-Section (i) of
Section 45 of the Copyright Act,
1957.Signature of the
Applicant
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14. Remarks, if any.
Signature
of the Applicant
Place:
Date:
Page: 2