Copyright Registration: Intake Form Please submit the following information via this online form, which is encrypted with SSL to help ensure the data you enter is secure. Name* Prefix Mr.Ms.Other First Middle Last Suffix Email* Enter Email Confirm Email Phone*Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Relationship to the Work*Are you the author, copyright claimant, and/or owner of exclusive rights to the work in question?YesNoContact Info in the Registration*How would you like to identify the copyright claimant (owner) in the Copyright Office’s official records? Note: persons searching the Copyright Office’s records may use the contact information provided to license or purchase the copyrighted work.Identify me as an individualIdentify me as a business/organizationProvide no contact informationName of Business Entity*DBA ("Assumed Name") of Business Entity*Country of Business Entity*AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabweState of Incorporation/Organization*AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificBusiness Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Type of Work*If more than one type of authorship is contained in a single work, select the type of work that applies to most of the content. For example, if you are registering a book that is mostly text but contains a few photographs, select “Literary work”. But if you are only claiming rights to a single type of authorship in the work, select the type of work that applies to the aspect for which you are claiming rights. For example, if you are registering a single photograph from a book, select “Work of the visual arts”.Literary work Includes: books, articles, fiction, nonfiction, poetry, textbooks, reference works, online works, directories, catalogs, advertising copy, compilations of information, computer programs, databases, article published in a serial Does not include: dramatic literary work, entire serial issueWork of the visual arts / pictorial, graphic, or sculptural work Includes: two-dimensional and three-dimensional works of fine, graphic, and applied art, photographs, prints and art reproductions, maps, technical drawings, architectural works, sketches, illustrationsSound recording Includes: sound recording alone, sound recording with the underlying literary/dramatic/musical work, production, performance Does not include: a motion picture/audiovisual work including soundsWork of the performing arts / dramatic or choreographic work Includes music with or without lyrics, screenplays, play or other script, pantomime Does not include: musical work including a sound recordingMotion picture / audiovisual work Includes: feature films, documentary films, television shows, videos, videogames, cinematographyPublished single serial issue Includes: periodicals, newspapers, magazines, bulletins, newsletters, annuals, journals, proceedings of societies Does not include: multiple serial issues, unpublished single serial issueTitle of Specific Work*Title of the work being registered (examples: song, TV episode, magazine article, book).Title of Larger Work*Title of the larger work (examples: album, TV series, full magazine, book series).Previous Title*Previous or alternative title.Whether Work is Published*Publication results from the distribution of copies 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 to a group of persons for purposes of further distribution, public performance, or public display. A public performance or display does not, by itself, constitute "publication".YesNoYear of Creation/Completion*Please enter a number from 1900 to 2020.Date/Approximate Date of First Publication* Date Format: MM slash DD slash YYYY Nation of First Publication*AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwePublication NumberInternational standard book number (ISBN), International standard recording code (ISRC), International standard serial number (ISSN), if applicable.Preregistration NumberCopyright Office preregistration number, if applicable.Author(s) of the Work*There may be a single author or multiple authors, and any of which may be an individual person or a company. Usually the author is the individual who is the actual creator of the work, but the author may be an employer for whom the work is being prepared as a work made for hire. For each author, include: the author’s full name, that the author wishes to remain anonymous, or that the author wishes to use a pseudonym and specify the pseudonym; the author’s country of citizenship and residence if not the United States; the author’s year of birth and year of death, if applicable; whether the work to be registered was made as a part of a work made for hire; and what type of contribution the author made (examples: text, editing, photograph, artwork, compilation, computer program).Owner(s)/Claimant(s) of the Work*There may be a single claimant or multiple claimants, and any of which may be an individual person or a company. Usually the author is also the copyright claimant, but the claimant may be the person or organization that has obtained ownership of all rights under the copyright through a legal transfer from the author. For each claimant, include: the claimant’s full name; the claimant’s address including the street address, city, state, and zip code. If the claimant is not the author, indicate how the claimant obtained the rights (examples: assignment, contract, inheritance, work made for hire).Whether a Derivative Work or a Compilation*A “derivative work” is a work that is based on or incorporates one or more preexisting works. Examples of derivative works include translations, fictionalizations, abridgments, musical arrangements, screenplays based on preexisting novels, reproductions of paintings, 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. A “compilation” is 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.Yes, it is based on or incorporates preexisting materialNo, it is wholly originalWhich Preexisting Work(s)*What specific preexisting work(s) is this current work based on? Provide the copyright registration number and year of registration, if known.Distinction to Preexisting Work(s)*How does the preexisting work(s) differ from the current work?Additional InformationPlease include any additional information you would like our attorneys to know.Disclaimer*Our attorneys may review the information you submit for the purposes described on this website. The use of this form for communication with our firm does not establish an attorney-client relationship. Our review of the information sent to us will not preclude us from representing any other client if confidential information is sent through this form.I agreeI do not agreeNameThis field is for validation purposes and should be left unchanged.
