Copyright Act, 1957
FORM IV - Application
for Registration of Copyright
(See Rule 16)
To
The Registrar of Copyrights,
Copyright Office,
New Delhi
Sir,
In accordance with Section 45 of the Copyright
Act, 1957 (14 of 1957), I hereby apply for registration of copyright and request
that entries may be made in the Register of Copyrights as in the enclosed
Statement of Particulars sent herewith in triplicate.
*I also send herewith Rule 16 of the Copyright
Rules, 1958, I have sent by prepaid registered post copies of this letter and
of the enclosed Statement (s) to the other parties **concerned, as shown
below:-
Names and addresses of the
parties Date of dispatch
1 2
*For Literary, Dramatic, Musical and Artistic
works only.
**See Coolum’s 7,11,12 and 13 of the Statement
of Particulars and the party referred to in Column 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 :-
[(Note: Ins. by G.S.R. 435(E), dt. 27-4-1992
(w.e.f. 27-4-1992)) I hereby declare that to the best of my knowledge and
belief, no person, other than to whom a notice has been sent as per paragraph 2
above any claim or interest or dispute to my copyright of this work or to its
use by me.]
[(Note: Ins. by G.S.R. 602(E), dt. 9-8-1984
(w.e.f. 9-8-1984)) (Note: Para 4-A renumbered as Para 6 by G.S.R. 435(E), dt.
27-4-1992 (w.e.f. 27-4-1992) I hereby verify that the particulars given in this
Form and 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.]
List of Enclosures
Place:
Date: Yours faithfully, Signature
Statement of Particulars
(To be sent in triplicate)
1. Registration Number (To be filled in the
Copyright Office).
2. Name, address and 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 and nationality of the author
and if the author is deceased, the date of his decease.
8. Whether work is published or unpublished.
9. Year and country of first publication and
name, address and nationality of the publisher.
10. Years and countries of subsequent
publications, if any, and names, address and nationalities of the publishers.
11. Names, addresses and nationalities of the
owners of the various rights comprising the copyright in the work and the
extent of rights held by each, together with particulars of assignments and
licenses, if any.
12. Names, addresses and nationalities of
other persons, if any, authorized to assign or license the rights comprising
the copyright.
13. If the work is an "Artistic
Work" which is used or is capable of being used in relation to any goods,
the application shall include a certificate from the Registrar of Trade Marks
in terms of the proviso to sub-section (i) of Section 45 of the Copyright Act,
1957.]
13-A. [(Note: Subs. by Noti. No. 435(E), dt.
27-4-1992 (w.e.f. 27-4-1992) for what was ins. by G.S.R. 602 (E), dt. 9-8-1984
(w.e.f. 9-8-1984)) If the work is an 'artistic work' which is used or is
capable of being used in relation to any goods, the application shall include a
certificate from the Registrar of Trade Marks in terms of the proviso to
sub-section (i) of Section 45 of the Copyright Act, 1957.]
14. Remarks, if any :
Place:
Date: Signature.
Statement of Further Particulars
(For Literary, Dramatic, Musical and Artistic
Works only)
(To be sent in triplicate)
1. Is the work to b registered?
(a) An original work ?
(b) A translation of a work in the public
domain?
(c) A translation of a work in which copyright
subsists?
(d) An adaptation of a work in the public
domain?
(e) An adaptation of a work in which copyright
subsists?
2. If the work is a translation or adaptation
of a work in which copyright subsists :-
(a) Title of the original work.
(b) Language of the original work.
(c) Name, address and nationality of the
author of the original work and if the author is deceased, the date of his
decease.
(d) Name, address and nationality of the publisher,
if any, of the original work.
(e) Particulars of the authorization for a
translation or adaptation including the name, address and nationality of the
party authorizing.
3. Remarks, if any.
Place:
Date: Signature.