CONTINUATION SHEET

FOR APPLICATION FORMS

● This Continuation Sheet is used in conjunction with Forms CA, PA, SE, SR, TX, and VA, only.

Indicate which basic form you are continuing in the space in the upper right-hand corner.

● If at all possible, try to fit the information called for into the spaces provided on the basic form.

● If you do not have enough space for all the information you need to give on the basic form, use

this Continuation Sheet and submit it with the basic form.

● If you submit this Continuation Sheet, clip (do not tape or staple) it to the basic form and fold the

two together before submitting them.

● Space A of this sheet is intended to identify the basic application.

Space B is a continuation of Space 2 on the basic application.

Space B is not applicable to Short Forms.

Space C (on the reverse side of this sheet) is for the continuation of Spaces 1, 4, or 6

on the basic application or for the continuation of Space 1 on any of the three

Short Forms PA, TX, or VA.

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

(Month) (Day) (Year)

CONTINUATION SHEET RECEIVED

EFFECTIVE DATE OF REGISTRATION

IDENTIFICATION OF CONTINUATION SHEET: This sheet is a continuation of the application for copyright registration

on the basic form submitted for the following work:

● TITLE: (Give the title as given under the heading "Title of this Work" in Space 1 of the basic form.)

Use the reverse side of this sheet if you need more space for continuation of Spaces 1, 4, or 6 of the basic form or for the

continuation of Space 1 on any of the Short Forms PA, TX, or VA.

NATURE OF AUTHORSHIP Briefly describe nature of the material created by the author in which copyright is claimed. ▼

DATES OF BIRTH AND DEATH

Year Born▼ Year Died▼

NATURE OF AUTHORSHIP Briefly describe nature of the material created by the author in which copyright is claimed. ▼

NAME OF AUTHOR ▼ DATES OF BIRTH AND DEATH

Year Born▼ Year Died▼

NATURE OF AUTHORSHIP Briefly describe nature of the material created by the author in which copyright is claimed. ▼

NAME OF AUTHOR ▼ DATES OF BIRTH AND DEATH

Year Born▼ Year Died▼

Identification

of

Application

A

Continuation

of Space 2

B

d

e

f

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

● NAME(S) AND ADDRESS(ES) OF COPYRIGHT CLAIMANT(S) : (Give the name and address of at least one copyright claimant

as given in Space 4 of the basic form or Space 2 of any of the Short Forms PA, TX, or VA.)

NAME OF AUTHOR ▼

WAS THIS AUTHOR’S CONTRIBUTION

TO THE WORK

Anonymous? ❏ Yes ❏ No

Pseudonymous? ❏ Yes ❏ No

If the answer to either

of these questions is

“Yes,” see detailed

instructions.

Was this contribution to the

work a “work made for hire”?

AUTHOR’S NATIONALITY OR DOMICILE

Name of Country

❏ Yes

❏ No

Citizen of

Domiciled in

OR{ ▼

▼

WAS THIS AUTHOR’S CONTRIBUTION

TO THE WORK

Anonymous? ❏ Yes ❏ No

Pseudonymous? ❏ Yes ❏ No

If the answer to either

of these questions is

“Yes,” see detailed

instructions.

Was this contribution to the

work a “work made for hire”?

AUTHOR’S NATIONALITY OR DOMICILE

Name of Country

❏ Yes

❏ No

Citizen of

Domiciled in

OR{ ▼

▼

If the answer to either

of these questions is

“Yes,” see detailed

instructions.

PA PAU SE SEG SEU SR SRU TX TXU VA VAU

Page of pages

WAS THIS AUTHOR’S CONTRIBUTION

TO THE WORK

Anonymous? ❏ Yes ❏ No

Pseudonymous? ❏ Yes ❏ No

Was this contribution to the

work a “work made for hire”?

AUTHOR’S NATIONALITY OR DOMICILE

Name of Country

❏ Yes

❏ No

Citizen of

Domiciled in

OR{ ▼

▼

3 Form ____ ⁄ CON UNITED STATES COPYRIGHT OFFICE

REGISTRATION NUMBER
C CONTINUATION OF (Check which): ❏ Space 1 ❏ Space 4 ❏ Space 6

Continuation

of other

Spaces

Certificate

will be

mailed in

window

envelope

to this

address:

DFees are subject

to change.

For current fees,

check the Copyright

Office website at

www.copyright.gov,

write the Copyright

Office, or call

(202) 707-3000.

September 2003 — 20,000 Web Rev: September 2003 E Printed on recycled paper U.S. Government Printing Office: 2003-496-605/60,034

Name ▼

Number/Street/Apt ▼

City/State/ZIP ▼

YOU MUST:

• Complete all necessary spaces

• Sign your application

SEND ALL 3 ELEMENTS

IN THE SAME PACKAGE:

1. Application form

2. Nonrefundable fee in check or

money order payable to Register

of Copyrights

3. Deposit Material

MAIL TO:

Library of Congress, Copyright Office

101 Independence Avenue, S.E.

Washington, D.C. 20559-6000