Copyright Office _ Application Form

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  • 4/15/2015 CopyrightOffice

    http://copyright.gov.in/FormIVPreview/frmFormIVPreview.aspx 1/5

    FORMXIVAPPLICATIONFORREGISTERATIONOFCOPYRIGHT

    [SEERULE70]DiaryNumber:2456/2015CO/L

    ToTheRegistrarofCopyrights,CopyrightOffice,NewDelhi:110001.

    Sir,InAccordancewithSection45oftheCoprightAct,1957(14of1957),Iherebyapplyforregistrationof

    CopyrightandrequestthatenteriesmaybemadeintheRegisterofCopyrightsasintheenclosedStatementofParticulars.

    1. I also send herewith duly completed the Statement of further Particulars relating to the work. (forLiterary/Dramatic,Musical,Atristicworksonly)Literary/Dramaticworks

    2.Inaccordancewithrule16oftheCopyrightRules,1958,IhavesentbyprepaidregisteredpostcopiesofthisletterandoftheStatementofParticularsandStatementofFurtherParticularstootherpartiesconcernedasshownbelow:

    NameofParty AddressofParty DateofDispatch

    S.SabareesanAssistantProfessor,DepartmentofMechanicalEngineering,PSNACollegeofEngineeringandTechnology,Dindigul624622

    16/03/2015

    S.KarthikAssistantProfessor,DepartmentofMechanicalEngineering,PSNAcollegeofEngineeringandTechnology,Dindigul.624622

    16/03/2015

    [Seecolumns7,11,12,and13oftheStatementofParticularsandpartyreferredincol.2(e)oftheStatementofFurtherParticulars.]

    3.Theprescribedfeehasbeenpaid,asperdetailsbelow:500/

    PaymentID PaymentDate Amount BankName PaymentMode125556 16/03/2015 500 ICICI NB

    4.Communicationsonthissubjectmaybeaddressedto: S.SabareesanAssistantProfessor,

    DepartmentofMechanicalEngineering,PSNAcollegeofEngineeringandTechnology,

    Dindigul.6246229445701437

    5.Iherebydeclarethattothebestofmyknowledgeandbelief,noperson,otherthantowhomanoticehasbeensentasperparagraph2aboveanyclaimorinterestordisputetomycopyrightofthisworkoritsusebyme.

    6.IherebyverifythattheparticularsgiveninthisFormandtheStatementofParticularsandStatmentofFurtherParticularsaretruetothebestofmyknowledge,beliefandinformationandnothinghasbeenconcealedtherefrom.

    ListofEnclosures:1.2CopiesofWork2.DD/IPOofRs.500PerWork3.Authorizationfromauthor/publisher4.Iftheapplicationisbeingfiledthroughattorney,aspecificPowerofAttorneyinoriginaldulysignedby

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    theapplicantandacceptedbytheattorney

    Place:

    Date:16/03/2015For:S.Sabareesan

    Proprietor

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    STATEMENTOFPARTICULARS(Tobesentintriplicate)

    DiaryNumber:2456/2015CO/L1. RegistrationNumber

    2. Name,AddressandNationalityoftheApplicant NAME:S.SabareesanADDRESS:AssistantProfessor,DepartmentofMechanicalEngineering,PSNAcollegeofengineeringandTechnology,Dindigul.624622,IndianNAME:S.KarthikADDRESS:AssistantProfessor,DepartmentofMechanicalEngineering,PSNAcollegeofEngineeringandTechnology,Dindigul.624622,Indian

    3. NatureoftheApplicant'sinterestintheCopyrightofthework

    Author

    4. Classanddescriptionofthework Literary/DramaticWork

    5. Titleofthework Portablebandsawcutter

    6. Languageofthework English

    7. Name,AddressandNationalityoftheAuthorandiftheAuthorisdeceased,thedateofdecease.

    NAME:S.SabareesanADDRESS:AssistantProfessor,DepartmentofMechanicalEngineering,PSNAcollegeofengineeringandTechnology,Dindigul.624622,IndianNAME:S.KarthikADDRESS:AssistantProfessor,DepartmentofMechanicalEngineering,PSNAcollegeofEngineeringandTechnology,Dindigul.624622,Indian

    8. WhethertheworkisPublishedorUnpublished Unpublished

    9. YearandCountryoffirstpublication,andName,AddressandNationalityofthepublisher

    N/A

    10. YearandCountriesofsubsequentpublications,ifany,andName,AddressandNationalityofthepublisher

    N/A

    11. Name,AddressandNationalityoftheOwnersofthevariousrightscomprisingthecopyrightintheworkandextentofrightsheldbyeach,togetherwithparticularsofassignmentsandlicence.Ifany

    NAME:S.SabareesanADDRESS:AssistantProfessor,DepartmentofMechanicalEngineering,PSNAcollegeofengineeringandTechnology,Dindigul.624622,IndianNAME:S.KarthikADDRESS:AssistantProfessor,DepartmentofMechanicalEngineering,PSNAcollegeofEngineeringandTechnology,Dindigul.624622,Indian

    12. Nameandaddressandnationalityofotherpersons,ifanyauthorizedtoassignorlicencetherightscomprisingthecopyright

    N/A

    13. Iftheworkisan'Artisticwork',thelocationoftheoriginalwork,includingname,addressandnationalityofthepersoninpossessionofthework,(Inthecaseofanarchitecturalwork,theyearofcompletionoftheworkshouldalsobeshown)

    N/A

    14. Iftheworkisan'Artisticwork'whichisusedorcapableofbeingusedinrelationtoanygoods,theapplicationshouldincludeacertificationfromtheRegistrarofTradeMarksintermsoftheprovisiontoSubSection(i)ofSection45oftheCopyrightAct,1957

    N/A

    15. Iftheworkisan'Artisticwork'whetheritisregisteredundertheDesingsAct2000ifyesgivedetails.

    N/A

    16. Iftheworkisan'Artisticwork'capableofbeing N/A

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    registrarasadesignundertheDesignsAct2000,whetherishasbeenappliedtoanarticlethoughanindustrialprocessand,ifyes,thennumberoftimesitisreproduced

    17. Remarks,ifany

    Place:Date:16/03/2015

    For:S.Sabareesan

    Proprietor

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    STATEMENTOFFURTHERPARTICULARS(Tobesentintriplicate)

    (ForLiterary/Dramatic,MusicalandArtisticworksonly)DiaryNumber:2456/2015CO/L

    1.Istheworktoberegistered

    (a)anorginalwork? : Yes

    (b)atranslationofaworkinthepublicdomain? : N.A.

    (c) a translation of awork inwhichCopyrightsubsists? : N.A.

    (d) an adaptation of a work in the publicdomain? : N.A.

    (e)anadaptationofaworkinwhichCopyrightsubsists? : N.A.

    2.Iftheworkisatranslationoradaptationofaworkinwhichcopyrightsubsists

    (a)Titleoftheoriginalwork : N.A.

    (b)Languageoftheoriginalwork : N.A.

    (c) Name, address, and nationality of theauthor of the original work and if the author isdeceased,thedateofdecease

    : N.A.

    (d) Name, address, and nationality of thepublisher,ifany,oftheoriginalwork : N.A.

    (e) Name, address, and nationality of thepublisher, or adaptation including the name, addressandnationalityofpartyauthorizing

    : N.A.

    3.Remarks,ifany

    Place:Date:16/03/2015

    For:S.Sabareesan

    Proprietor