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Request For Certificate Of Copyright Registration
To: Register of Copyrights
Library of Congress
Washington, D.C. 20559
Re: Registration number _____________,
issued to _________ (owner of copyright), _________ (address of copyright owner)
Being owner of the previously mentioned copyright, I hereby make request, for a copy of the certificate of registration issued with respect to such copyright (pursuant to Title 37, Section 201.2(d)(1) of the Code of Federal Regulations).
Enclosed with this request is a check in the amount of ______ payable to the Register of Copyrights, in payment of the required copying fee.
Signature: _____________________ (copyright owner)