BASIC INFORMATION

Name of Author: The fullest form of the author’s name should be

given.Unless the work was “made for hire,” the individual who actually created

the work is its “author.” In the case of a work made for hire, the statute provides

that “the employer or other person for whom the work was prepared is

considered the author.”

What is a “Work Made for Hire”? A “work made for hire” is defined as:

(1) “a work prepared by an employee within the scope of his or her employment”; or (2) “a work specially ordered or commissioned for use as a contribution to a collective work, as a part of a motion picture or other audiovisual work,

as a translation, as a supplementary work, as a compilation, as an instructional

text, as a test, as answer material for a test, or as an atlas, if the parties expressly

agree in a written instrument signed by them that the work shall be considered

a work made for hire.” If you have checked “Yes” to indicate that the work was

“made for hire,” you must give the full legal name of the employer (or other

person for whom the work was prepared). You may also include the name of the

employee along with the name of the employer (for example: “Elster Publishing

Co., employer for hire of John Ferguson”).

“Anonymous” or “Pseudonymous” Work: An author’s contribution to a

work is “anonymous” if that author is not identified on the copies or phonorecords

of the work. An author’s contribution to a work is “pseudonymous” if that author

is identified on the copies or phonorecords under a fictitious name. If the work

is “anonymous” you may: (1) leave the line blank; or (2) state “anonymous” on

the line; or (3) reveal the author’s identity.If the work is “pseudonymous” you

may: (1) leave the line blank; or (2) give the pseudonym and identify it as such

(for example: “Huntley Haverstock, pseudonym”); or (3) reveal the author’s

name, making clear which is the real name and which is the pseudonym (for

example: “Henry Leek, whose pseudonym is Priam Farrel”). However, the

citizenship or domicile of the author must be given in all cases.

Dates of Birth and Death: If the author is dead, the statute requires that the

year of death be included in the application unless the work is anonymous or

pseudonymous. The author’s birth date is optional but is useful as a form of

identification. Leave this space blank if the author’s contribution was a “work

made for hire.”

SPACE 1: Title

Title of This Work: Every work submitted for copyright registration

must be given a title to identify that particular work.If the copies of the

work bear a title (or an identifying phrase that could serve as a title),

transcribe that wording completely and exactly on the application. Indexing of the

registration and future identification of the work will depend on the information

you give here. For an architectural work that has been constructed, add the date

of construction after the title; if unconstructed at this time, add “not yet constructed.”

Publication as a Contribution: If the work being registered is a contribution

to a periodical, serial, or collection, give the title of the contribution in the “Title

of This Work” space. Then, in the line headed “Publication as a Contribution,”

give information about the collective work in which the contribution appeared.

Nature of This Work: Briefly describe the general nature or character of the

pictorial, graphic, or sculptural work being registered for copyright.Examples:

“Oil Painting”; “Charcoal Drawing”; “Etching”; “Sculpture”; “Map”; “Photograph”; “Scale Model”; “Lithographic Print”; “Jewelry Design”; “Fabric Design.”

Previous or Alternative Titles: Complete this space if there are any additional

titles for the work under which someone searching for the registration might be

likely to look, or under which a document pertaining to the work might be

recorded.

SPACE 2: Author(s)

General Instruction: After reading these instructions, decide who are

the “authors” of this work for copyright purposes. Then, unless the work

is a “collective work,” give the requested information about every

“author” who contributed any appreciable amount of copyrightable matter to this

version of the work. If you need further space, request Continuation Sheets. In

the case of a collective work, such as a catalog of paintings or collection of

cartoons by various authors, give information about the author of the collective

work as a whole.

Please type or print using black ink. The form is used to produce the certificate.

1

2

LINE-BY-LINE INSTRUCTIONS

Architectural Works: Copyright protection extends to the design of buildings

created for the use of human beings. Architectural works created on or after

December 1, 1990, or that on December 1, 1990, were unconstructed and

embodied only in unpublished plans or drawings are eligible. Request Circular

41 for more information. Architectural works and technical drawings cannot be

registered on the same application.

Deposit to Accompany Application: An application for copyright registration

must be accompanied by a deposit consisting of copies representing the entire

work for which registration is to be made.

Unpublished Work: Deposit one complete copy.

Published Work: Deposit two complete copies of the best edition.

Work First Published Outside the United States: Deposit one

complete copy of the first foreign edition.

Contribution to a Collective Work: Deposit one complete copy of

the best edition of the collective work.

The Copyright Notice: Before March 1, 1989, the use of copyright notice was

mandatory on all published works, and any work first published before that date

should have carried a notice. For works first published on and after March 1,

1989, use of the copyright notice is optional. For more information about

copyright notice, see Circular 3, “Copyright Notice.”

For Further Information:To speak to an information specialist, call (202) 707-

3000 (TTY: (202) 707-6737). Recorded information is available 24 hours a day.

Order forms and other publications from the address in space 9 or call the Forms

and Publications Hotline at (202) 707-9100. Most circulars (but not forms) are

available via fax. Call (202) 707-2600 from a touchtone phone. Access and

download circulars, forms, and other information from the Copyright Office

website at www.copyright.gov.

When to Use This Form: Use Form VA for copyright registration of published

or unpublished works of the visual arts. This category consists of “pictorial,

graphic, or sculptural works,” including two-dimensional and three-dimensional

works of fine, graphic, and applied art, photographs, prints and art reproductions,

maps, globes, charts, technical drawings, diagrams, and models.

What Does Copyright Protect? Copyright in a work of the visual arts protects

those pictorial, graphic, or sculptural elements that, either alone or in combination,

represent an “original work of authorship.” The statute declares: “In no case does

copyright protection for an original work of authorship extend to any idea,

procedure, process, system, method of operation, concept, principle, or discovery,

regardless of the form in which it is described, explained, illustrated, or embodied

in such work.”

Works of Artistic Craftsmanship and Designs: “Works of artistic

craftsmanship” are registrable on Form VA, but the statute makes clear that

protection extends to “their form” and not to “their mechanical or utilitarian

aspects.” The “design of a useful article” is considered copyrightable “only if, and

only to the extent that, such design incorporates pictorial, graphic, or sculptural

features that can be identified separately from, and are capable of existing

independently of, the utilitarian aspects of the article.”

Labels and Advertisements: Works prepared for use in connection with the sale

or advertisement of goods and services are registrable if they contain “original

work of authorship.” Use Form VA if the copyrightable material in the work you

are registering is mainly pictorial or graphic; use Form TX if it consists mainly of

text. NOTE: Words and short phrases such as names, titles, and slogans cannot

be protected by copyright, and the same is true of standard symbols, emblems, and

other commonly used graphic designs that are in the public domain. When used

commercially, material of that sort can sometimes be protected under state laws

of unfair competition or under the federal trademark laws. For information about

trademark registration, write to the Commissioner of Patents and Trademarks,

Washington, D.C. 20231.

b Form VA b

Detach and read these instructions before completing this form.

Make sure all applicable spaces have been filled in before you return this form.
Author’s Nationality or Domicile: Give the country of which the author is

a citizen or the country in which the author is domiciled.Nationality or domicile

must be given in all cases.

Nature of Authorship: Catagories of pictorial, graphic, and sculptural

authorship are listed below. Check the box(es) that best describe(s) each author’s

contribution to the work.

3-Dimensional sculptures: fine art sculptures, toys, dolls, scale models, and

sculptural designs applied to useful articles.

2-Dimensional artwork:watercolor and oil paintings; pen and ink drawings;

logo illustrations; greeting cards; collages; stencils; patterns; computer graphics;

graphics appearing in screen displays; artwork appearing on posters, calendars,

games, commercial prints and labels, and packaging, as well as 2-dimensional

artwork applied to useful articles, and designs reproduced on textiles, lace, and

other fabrics; on wallpaper, carpeting, floor tile, wrapping paper, and clothing.

Reproductions of works of art: reproductions of preexisting artwork made

by, for example, lithography, photoengraving, or etching.

Maps: cartographic representations of an area, such as state and county maps,

atlases, marine charts, relief maps, and globes.

Photographs: pictorial photographic prints and slides and holograms.

Jewelry designs: 3-dimensional designs applied to rings, pendants, earrings,

necklaces, and the like.

Technical drawings: diagrams illustrating scientific or technical information in linear form, such as architectural blueprints or mechanical drawings.

Text: textual material that accompanies pictorial, graphic, or sculptural

works, such as comic strips, greeting cards, games rules, commercial prints or

labels, and maps.

Architectural works: designs of buildings, including the overall form as well

as the arrangement and composition of spaces and elements of the design.

NOTE: Any registration for the underlying architectural plans must be

applied for on a separate Form VA, checking the box “Technical drawing.”

SPACE 3: Creation and Publication

General Instructions: Do not confuse “creation” with “publication.”

Every application for copyright registration must state “the year in which

creation of the work was completed.” Give the date and nation of first

publication only if the work has been published.

 Creation: Under the statute, a work is “created” when it is fixed in a copy

or phonorecord for the first time. Where a work has been prepared over a period

of time, the part of the work existing in fixed form on a particular date constitutes

the created work on that date.The date you give here should be the year in which

the author completed the particular version for which registration is now being

sought, even if other versions exist or if further changes or additions are planned.

Publication: The statute defines “publication” as “the distribution of copies

or phonorecords of a work to the public by sale or other transfer of ownership,

or by rental, lease, or lending”; a work is also “published” if there has been an

“offering to distribute copies or phonorecords to a group of persons for purposes

of further distribution, public performance, or public display.” Give the full date

(month, day, year) when, and the country where, publication first occurred. If

first publication took place simultaneously in the United States and other

countries, it is sufficient to state “U.S.A.”

SPACE 4: Claimant(s)

Name(s) and Address(es) of Copyright Claimant(s): Give the name(s)

and address(es) of the copyright claimant(s) in this work even if the

claimant is the same as the author. Copyright in a work belongs initially

to the author of the work (including, in the case of a work make for hire, the

employer or other person for whom the work was prepared). The copyright

claimant is either the author of the work or a person or organization to whom the

copyright initially belonging to the author has been transferred.

 Transfer: The statute provides that, if the copyright claimant is not the

author, the application for registration must contain “a brief statement of how the

claimant obtained ownership of the copyright.” If any copyright claimant named

in space 4 is not an author named in space 2, give a brief statement explaining how

the claimant(s) obtained ownership of the copyright. Examples: “By written

contract”; “Transfer of all rights by author”; “Assignment”; “By will.” Do not

attach transfer documents or other attachments or riders.

SPACE 5: Previous Registration

General Instructions: The questions in space 5 are intended to find out

whether an earlier registration has been made for this work and, if so,

whether there is any basis for a new registration.As a rule, only one basic

PRIVACY ACT ADVISORY STATEMENT Required by the Privacy Act of 1974 (P.L. 93 - 579)

The authority for requesting this information is title 17, U.S.C., secs. 409 and 410.Furnishing the

requested information is voluntary.But if the information is not furnished, it may be necessary to

delay or refuse registration and you may not be entitled to certain relief, remedies, and benefits

provided in chapters 4 and 5 of title 17, U.S.C.

The principal uses of the requested information are the establishment and maintenance of a public

record and the examination of the application for compliance with the registration requirements of

the copyright code.

Other routine uses include public inspection and copying, preparation of public indexes, preparation of public catalogs of copyright registrations, and preparation of search reports upon request.

NOTE: No other advisory statement will be given in connection with this application.Please keep

this statement and refer to it if we communicate with you regarding this application.

3

4

5

6

7,8,9

copyright registration can be made for the same version of a particular work.

Same Version: If this version is substantially the same as the work covered

by a previous registration, a second registration is not generally possible unless:

(1) the work has been registered in unpublished form and a second registration

is now being sought to cover this first published edition; or (2) someone other than

the author is identified as a copyright claimant in the earlier registration, and the

author is now seeking registration in his or her own name.If either of these two

exceptions applies, check the appropriate box and give the earlier registration

number and date. Otherwise, do not submit Form VA; instead, write the

Copyright Office for information about supplementary registration or recordation of transfers of copyright ownership.

 Changed Version: If the work has been changed and you are now seeking

registration to cover the additions or revisions, check the last box in space 5, give

the earlier registration number and date, and complete both parts of space 6 in

accordance with the instruction below.

 Previous Registration Number and Date: If more than one previous

registration has been made for the work, give the number and date of the latest

registration.

SPACE 6: Derivative Work or Compilation

General Instructions: Complete space 6 if this work is a “changed

version,” “compilation,” or “derivative work,” and if it incorporates one

or more earlier works that have already been published or registered for

copyright, or that have fallen into the public domain.A “compilation” is defined

as “a work formed by the collection and assembling of preexisting materials or

of data that are selected, coordinated, or arranged in such a way that the resulting

work as a whole constitutes an original work of authorship.” A “derivative work”

is “a work based on one or more preexisting works.” Examples of derivative

works include reproductions of works of art, sculptures based on drawings,

lithographs based on paintings, maps based on previously published sources, or

“any other form in which a work may be recast, transformed, or adapted.”

Derivative works also include works “consisting of editorial revisions, annotations, or other modifications” if these changes, as a whole, represent an original

work of authorship.

 Preexisting Material (space 6a): Complete this space and space 6b for

derivative works.In this space identify the preexisting work that has been recast,

transformed, or adapted.Examples of preexisting material might be “Grunewald

Altarpiece” or “19th century quilt design.” Do not complete this space for

compilations.

 Material Added to This Work (space 6b): Give a brief, general statement

of the additional new material covered by the copyright claim for which

registration is sought.In the case of a derivative work, identify this new

material.Examples: “Adaptation of design and additional artistic work”; “Reproduction of painting by photolithography”; “Additional cartographic material”;

“Compilation of photographs.” If the work is a compilation, give a brief, general

statement describing both the material that has been compiled and the compilation itself.Example: “Compilation of 19th century political cartoons.”

SPACE 7,8,9: Fee, Correspondence,

Certification, Return Address

Deposit Account: If you maintain a Deposit Account in

the Copyright Office, identify it in space 7a. Otherwise, leave the space blank

and send the fee of $30 with your application and deposit.

 Correspondence (space 7b): This space should contain the name, address,

area code, telephone number, email address, and fax number (if available) of

the person to be consulted if correspondence about this application becomes

necessary.

 Certification (space 8): The application cannot be accepted unless it bears

the date and the handwritten signature of the author or other copyright

claimant, or of the owner of exclusive right(s), or of the duly authorized agent

of the author, claimant, or owner of exclusive right(s).

 Address for Return of Certificate (space 9): The address box must be

completed legibly since the certificate will be returned in a window envelope.
DO NOT WRITE ABOVE THIS LINE. IF YOU NEED MORE SPACE, USE A SEPARATE CONTINUATION SHEET.

1

3

4

Title of This Work ▼ NATURE OF THIS WORK ▼ See instructions

Previous or Alternative Titles ▼

Publication as a Contribution If this work was published as a contribution to a periodical, serial, or collection, give information about the collective work in which the

contribution appeared. Title of Collective Work ▼

If published in a periodical or serial give: Volume ▼ Number ▼ Issue Date ▼ On Pages ▼

NAME OF AUTHOR ▼ DATES OF BIRTH AND DEATH Year Born ▼ Year Died ▼

Nature of Authorship Check appropriate box(es).See instructions

 3-Dimensional sculpture  Map  Technical drawing

 2-Dimensional artwork  Photograph  Text

 Reproduction of work of art  Jewelry design  Architectural work

Name of Country

Citizen of {Domiciled in

Was this contribution to the work a

“work made for hire”?

OR  Yes

 No

2

Name of Author ▼ Dates of Birth and Death

 Year Born ▼ Year Died ▼

Nature of Authorship Check appropriate box(es).See instructions

 3-Dimensional sculpture  Map  Technical drawing

 2-Dimensional artwork  Photograph  Text

 Reproduction of work of art  Jewelry design  Architectural work

Name of Country

Citizen of {Domiciled in

Was this contribution to the work a

“work made for hire”?

OR  Yes

 No

Author's Nationality or Domicile

Author's Nationality or Domicile

NOTE

Under the law,

the “author” of

a “work made

for hire” is

generally the

employer, not

the employee

(see instructions). For any

part of this

work that was

“made for hire”

check “Yes” in

the space

provided, give

the employer

(or other

person for

whom the work

was prepared)

as “Author” of

that part, and

leave the

space for dates

of birth and

death blank.

Year in Which Creation of This Work Was

Completed This information

must be given

in all cases.

Date and Nation of First Publication of This Particular Work

Complete this information

ONLY if this work

has been published.

COPYRIGHT CLAIMANT(S) Name and address must be given even if the claimant is the same as the

author given in space 2. ▼

Transfer If the claimant(s) named here in space 4 is (are) different from the author(s) named in space 2, give a

brief statement of how the claimant(s) obtained ownership of the copyright. ▼

APPLICATION RECEIVED

ONE DEPOSIT RECEIVED

TWO DEPOSITS RECEIVED

FUNDS RECEIVED

Year b

b

a Month Day Year

Nation

MORE ON BACK DO NOT WRITE HERE

Page 1 of pages

▼

• Complete all applicable spaces (numbers 5-9) on the reverse side of this page.

• See detailed instructions. • Sign the form at line 8.

DO NOT WRITE HERE

OFFICE USE ONLY

See instructions

before completing

this space.

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 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.

a

Copyright Office fees 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.

FORM VA b

For a Work of the Visual Arts

UNITED STATES COPYRIGHT OFFICE

REGISTRATION NUMBER

 VA VAU

EFFECTIVE DATE OF REGISTRATION

 Month Day Year
EXAMINED BY

CHECKED BY

CORRESPONDENCE

Yes

DERIVATIVE WORK OR COMPILATION Complete both space 6a and 6b for a derivative work; complete only 6b for a compilation.

a. Preexisting Material Identify any preexisting work or works that this work is based on or incorporates. ▼

b. Material Added to This Work Give a brief, general statement of the material that has been added to this work and in which copyright is claimed. ▼

DEPOSIT ACCOUNT If the registration fee is to be charged to a Deposit Account established in the Copyright Office, give name and number of Account.

Name ▼ Account Number ▼

CORRESPONDENCE Give name and address to which correspondence about this application should be sent. Name/Address/Apt/City/State/ZIP ▼

Area code and daytime telephone number ( ) Fax number ( )

Email

CERTIFICATION* I, the undersigned, hereby certify that I am the

 author

 other copyright claimant

 owner of exclusive right(s)

 authorized agent of

 Name of author or other copyright claimant, or owner of exclusive right(s)▲

of the work identified in this application and that the statements made by me in this application are correct to the best of my knowledge.

5

7

8

6

FORM VA

FOR

COPYRIGHT

OFFICE

USE

ONLY

DO NOT WRITE ABOVE THIS LINE. IF YOU NEED MORE SPACE, USE A SEPARATE CONTINUATION SHEET.

PREVIOUS REGISTRATION Has registration for this work, or for an earlier version of this work, already been made in the Copyright Office?

 Yes  No If your answer is “Yes,” why is another registration being sought? (Check appropriate box.) ▼

a.  This is the first published edition of a work previously registered in unpublished form.

b.  This is the first application submitted by this author as copyright claimant.

c.  This is a changed version of the work, as shown by space 6 on this application.

If your answer is “Yes,” give: Previous Registration Number ▼ Year of Registration ▼

Name ▼

Number/Street/Apt ▼

City/State/ZIP ▼

*17 U.S.C. § 506(e): Any person who knowingly makes a false representation of a material fact in the application for copyright registration provided for by section 409, or in any written statement filed in connection

with the application, shall be fined not more than $2,500.

See instructions

before completing

this space.

YOU MUST:

• Complete all necessary spaces

• Sign your application in space 8

SEND ALL 3 ELEMENTS

IN THE SAME PACKAGE:

1. Application form

2. Nonrefundable filing 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



Certificate

will be

mailed in

window

envelope

to this

address:

b

a

a

b

check only one ▼ {

 Handwritten signature (X) ▼

Typed or printed name and date ▼ If this application gives a date of publication in space 3, do not sign and submit it before that date.

Date

X

9Fees 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.

Rev: June 2002—20,000 Web Rev: June 2002 E Printed on recycled paper U.S. Government Printing Office: 2000-461-113/20,021