| Call 561-235-0725, or fill out the form below for a |
| CONFIDENTIAL INSTANT QUOTE ESTIMATE FOR A |
| COPYRIGHT APPLICATION |
| by copyright attorney, Peter A. Koziol, Esq. |
| |
| |
| Are you the:
claimant/Owner
author
Both
Not Sure
| [?] |
| Please enter your e-mail address: |
| |
| Please enter your telephone number: |
| |
| Please enter the title of the original work of authorship: |
| [?] |
|
| Please check each box that is appropriate: |
|
The work is a work for hire created within the scope of employment. | [?] |
|
The work was part of a specially commissioned work for hire subject to a written work for hire agreement. | [?] |
|
I do NOT understand the two previous checkboxes. | [?] |
|
| Please enter the full name of the primary author: |
| [?] |
| Please enter the address of the primary author: |
| [?] |
| |
|
|
| Please enter the full name and address of each co-author: |
| [?] |
| Please enter the full name of the claimant: |
| [?] |
| Please enter the address of the claimant: |
| [?] |
| |
|
|
| Please enter the full name and address of each additional claimant: |
| [?] |
| Please enter any cross-references to related works: |
| [?] |
| Please enter any statement regarding sponsored research or development: |
| [?] |
|
| Please select a file of the best electronic copy of the original work of authorship that you wish to apply to register: |
| [?] |
| Please enter a description of the deposit copy: |
| [?] |
| Please enter a description of the appearace of portions of the work that are not included in the deposit: |
| [?] |
| Please enter a description of portions of the work that are disclaimed: |
| [?] |
| Please enter any additional notes or special requests: |
| [?] |
|
