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STATEMENT OF PARTICULARS

Applicant Name *

Type of Applicant *

Full Name of Signatory *

Designation of Signatory *

Nature of Business

Address

District

Pin Code

State

Nationality

Country

Applicant Signature *

Signature File type:

jpg and jpeg format
File size Less than 512 KB.

Nature of the applicant's interest in the copyright of the work *

Class of the work *

Description of the work

Characters:200

Title of the work *

Language of the work *

Name, address and nationality of the author and if the author is deceased, the date of his decease. *

Same as Applicant

Name

Full Address

Pincode

Nationality

Date of decease

Whether work is Published or unpublished ?

Published

Unpublished

Year and country of first publication and name, address and nationality of the publisher.

Same as Applicant

Same as Auther

Name

Full Address

Pincode

Nationality

Country

Year of Publish

Years and countries of subsequent publication, if any, and names, addresses and nationalities of the publishers.

Same as Applicant

Same as Auther

Same as Publisher

Name

Full Address

Pincode

Nationality

Country

Year of subsequent Publish

If the work is an 'Artistic work' capable of being registered as a design under the Design Act 2000, whether it has been applied to an article though an industrial process and if yes, the number of times it is reproduced

Not Applicable

Number

Is the work to be registered

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.

Name

Address

Nationality

Date of decease

(d) Name, address, and nationality of the publisher, if any, of the original work.

Name

Address

Nationality

(e) Particulars of the authorization for a translation or adaption including the name, address, and nationality of the party authorizing.

Name

Address

Nationality

Remarks, if any.

Characters:200

Copyright

STATEMENT OF PARTICULARS