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Application for Registration of a Copyright
For assistance in completing the form, please refer to the "Instructions" sheet. Please print.
2. Category of the work
Select the category or categories that best describe your work.
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Date of first publication Y M D |
Place of publication: City/Town (optional) |
Prov./State (optional) |
Country |
__ __ __ | _______________ | ________________ | ______________ |
4. Author(s) |
Same as owner(s) (if author is "same as owner" go to section 5 -
if more than one author, please attach a list of names and addresses
of all the authors) |
Family name |
First name |
Initial |
If deceased, date of author's death: |
_________________ |
_________________ |
____ |
Y___ M___ D___ |
Address |
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City/Town |
Prov./State |
Country |
Postal/ZIP code |
_____________ |
____________ |
____________ |
____________ |
5. Owner(s) - (If more than one owner, please
attach a list of names and addresses of all the owners) |
A. Family name |
First name |
Initial |
______________________ |
______________________ |
___ |
OR B. Name of corporation |
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Address |
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City/Town |
Prov./State |
Country |
Postal/ZIP code |
_____________ |
____________ |
____________ |
____________ |
7. Agent (if applicable) |
A. Family name |
First name |
Initial |
______________________ |
______________________ |
___ |
OR B. Name of firm |
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Address |
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City/Town |
Prov./State |
Country |
Postal/ZIP code |
_____________ |
____________ |
____________ |
____________ |
Telephone no. |
Fax no. (if available) |
E-mail (if available) |
(____)_____________ |
(____)______________ |
______________________ |
(For Canadian Intellectual Property Office use only) |
All correspondence should be addressed to:
Copyright Office
Canadian Intellectual Property Office
Industry Canada
Place du Portage I
50 Victoria Street
Gatineau, QC K1A 0C9 |
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Telephone: (819) 997-1936
Facsimile: (819) 997-6357
Internet address: www.cipo.gc.ca/copyrights
E-mail: cipo.contact@ic.gc.ca
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Please do not send copies of your work.
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