You are on page 1of 11
For Voseol suit baa UNITED STATES COPYRIGHT OFFICE REGISTRATION NUMBER FORM D-VH @ DUH 0094 SATEOF REGISTRATION PUSLICATION Juty 23, 2002 Mee Dey Yee DONOT WRITE ABOVE THIS LINE. If YOU NEED MORE SPACE, USE A SEPARATE CONTINUATION SHEET. (Form D-VHICOR) Please give the make and model of the vessel that embodies the design. rae FS |S EXTENDED Canrer Consore ‘he type or style of the design for which registration le sought (a) Fipegcie2es DY wih ExXTEWOED Tegan, (b) "eyes Provide a brief ; Statement sting fr he salient cares of tn design, PSIgN PE AWO DESIGN EXTENDED Teedsom, DECK LArour Remsumes" ae DEsIEN ESSTUEGS 1 SXTMNDED Teena Om TITLE Provide the name and address ofthe designer(s). The name of the employer may be given instead of the designer(s)if, (1) the design was mae win three scope of employment othe designe) andthe ndvdual autor oft designs dfx or impossible to asc DESIGNERS) ese coc hee thos opons rests and you ar providing the employers name, Name: DYNASTY BOATS INC Name: Address: 2U4S US. Huy 31 N “Address: MINE MonT At A ’ 35179. ‘lf the owner is differeat from the designer(s) or employer named above, provide the name and address of the owner: Name: Same 44 agove . OWNER, “ IF NOT Adress: DESIGNERS) ‘Was an application for registration ofthis design identified (b) es If yes, (a) inan applcaion fled in forcign country that extends to desis of owner who ae cuzesof he Une States ot Pmroriry © Bens filing applications inthe United States, similar Date of application: protection ip that afforded in 17 U.S.C. chapter 132 CLAM yes No Secal No: ‘Was this design made public before the date of application Ml Yes O No [2 ey ‘APPUCATION RECEIVED It yes, on what date? wet IS tek [Hes consceu HA2 2002 — DATE MADE eae Be Funns peceneo MAY. 2 8,,2002_ CRECRED BY {BRECON Fon 0 COPYRIGHT es ‘OFRCE Use ont DONOT WRITE ABOVE THIS LINE. IF YOU NEED MORE SPACE, USE A SEPARATE CONTINUATION SHEET. Please provide the name and address of the person to whom correspondence regarding this application may be directed / Name: _RoceR YARBOROUGH CONTACT adress: 2IAS VS Hwy BIN 35979 Ze PERSON E-mail address TYARBOROOGHA) POG Bats ~Com FAXnumber 256° 739 ' FBS anime phone: (256 ) 7239-4182 ST ‘Give the name and account number if the registration fee is to be charged 10a Deposit Account established in the Copyright Office: 8 Name of Account: Noe DEPOSIT Account number: ACCOUNT. i DECLARATION: The undersigned, as the applicant or the applicants duly appointed agent or representative, being hereby wamed that willful false statements are punishable by fine or imprisonment, or both, under 18 U.S.C: §1001, and that such willful false ‘statements may jeopardize the validity of this application or any resulting registration, hereby declares to the best of his/herknowiedge and belief: (1) that the. ‘has been fixed in a uscfut article; (2) that the design is original and was created by the designer(s), or employer if applicable, named in the application, ‘G) that chose aspects ofthe design for which registration is sought are not protected by a design patent; 4) that the design has not previously been registered on behalf of the applicant or applicant's predecessor in title; and (5) that the applicant isthe person entitled to protection and to registration under chapter 13 of title 17, United States Code. Complete if applicable: ‘The design has been made public with a design Following isthe exact form ofthe design notice; ~Emccesen Una ‘Where on the useful article is the design notice iSem= ON TRALSOM NEXT 1 Se@iAc NOMBER, CERTIFICATION AND ‘SWORN STATEMENTS ‘ie not thefappticas,helsk 1 authorized to execute this application on behalf ofthe applicant. Go 326,02 Bee ——_ STS ‘Roce VoKponoue SEVERAL MAN AGEN Fararypa sane rasa 256:739. 4192 256 739 41357 fe YARBOr U6 HO Poine BoaTs.& Tea Fanaa FR puck CAST CRT Rees) Boreas Re ht, 0 Mail wane por —_ annem Dynasty Boorse INC, aes vibe "ZN 45US Hwy BIN, Setar emer mailed in ERaaPT cwvelope Nunemont Ara 35'79 ae oe Fe a IS es Ba roe jam ae