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FORM D-VH For Vessel Hull Design UNITED STATES COPYRIGHT OFFICE REGISTRATION NUMBER DUH 0152 DATE OF REGISTRATION PUBLICATION Oct. 1, 2003 DO NOT WRITE ABOVE THIS LINE. IF YOU NEED MORE SPACE, USE A SEPARATE CONTINUATION SHEET. (Form D-VHICON) 1 Please give the make and model of the vessel that embodies the design. Four Winns 230 Horizon TITLE - ‘What is the type or style of the design for which registration is sought? (a) Mm BE gan ge i gehen ee aH ((b) Provide abriefaeneal saiement suing fr the salient fears ofthe design, DESIGN Sizing, proportioning and shaping that provide aesthetic value along with WBoneck nara i maximiz er Bloneck neve it mizing funtionality per size. esi. Chek nar if ‘agistering (c)_ this design is derived from an eater design, describe how that design has been revised, adapted, or earanged. aeicee oreon oy "$B ene Es i Wh PEE AMM ARAN Provide the name and adaress of the designer() The name ofthe employer may be given instead ofthe designers) if (1)the design was made within the eglarscopeof employment ofthe designer) and 2 the individual authoshipof he design Re or impossible wo ascribe DESIGNERG) 1 Please check here if those conditions are satisfied and you are providing the employer's mame. Name: Tom Wenstadt _ Nome: Barry Parker ‘Address: 4721 Forest Ridge Dr. Address:3527 N- 45 1/2 Road Cadillac, MI 4960100 Manton, MI_49663 00 If the owner is different from the designer(s) or employer named above, provide the name and address of the owner: Name; _Four Winns Boats, LLC. OWNER, “Address: 925 Frisbie St. I NoT : Cadillac, MI 49601 DESIGNERS) aq) Wabsnagplcan foregsraon of his design Meniied (yy If yes, Ren the county and date of plication: () in an application filed ina foreign country that extends to (D) Counuys designs of owners who are citizens of the United States, or Ae tw peions filing applicaons inte United Stats, similar Date of application: Pl protection to that afforded in 17 U.S.C. chapter 13? CLAIM Oyes HNo . Serial No: _ ‘Was this design made public before the dat of application? B8 Yes Cl No Jy =e ae Myes co what dae? duly 2 aga sa co ER. : Simao: [recamcmas SEP 22 208 PUBLIC MARE ON nan *Eompite ah apploase specss acer yD Sethe eres ce oT Pade EXAMINED BY FORM DVT rECREDY ee CORRESPONDENCE corfu aves OPHICE Use ony 0 NOT WRITE ABOVE THIS LINE. IF YOU NEED MORE SPACE, USE A SEPARATE CONTNUATION SHEET. Form DVHTCOM)_— Please provide the name and address of the person to whom correspondence regarding tis application may be directed / Name: Tom Wenstadt __ CONTACT gdress; 905 Frisble St. person A“ = = Cadillac, MI 49061 Eimail address tWensta. FAX number 231°779-2362_ Daytime phone: (231) 279-2333 | Give the name and account number ifthe registration fe is tobe charged toa Deposit Accountestablished inthe Copyright fice: Name of Account: DEPOSIT Account number: ACCOUNT DECLARATION: The undersigned, asthe applicant or the applicant's duly appointed agent or representative, being hereby warned. that willfl false statements are punishable by fine or imprisonment, or both, under 18 U.S.C. $1001, and that sueh willful false statements may jeopardize the validity ofthis application orany resulting registration, hereby declaresto thebestof hisorher knowledge and belief (1) that te design has been fixed in a useful article; (2) that the design is orginal and was created by the designe(s), or employer if applicable, named in the application; (3) that those aspects ofthe design for whic registration is sought are not protected by a design patent; (@) that the design has not previously been registered on behalf ofthe applicant or applicant's predecessor in tie; and (6) thatthe applicant isthe person entitled to protection and to registration under chapter 13 of ttle 17, United States Code Complete if applicable: ‘The design has been made public with a design notice as prescribed by 17 U.S.C. $1306. Following is the exact form of the design notice: PROTECTED DESIGN Four Winns Bi s, LLC. 2003 CERTIFICATION AND SWORN STATEMENTS Where on the useful aticre isthe design notice located? If the undersigned isnot the applicant, he or she is properly authorized to execute this application on behalf ofthe applicant i, e 2-1¢-02 Contitieate see will be mailed in Tom Wenstadt window | janeeiSiealaer envelope tothis 905 Frisbie st. address: Teta Regan issejan Uae gar m ‘Seg vce chap sly apna of as han S20 atx mow an 00, ny hs of rege thecal Moy ave he dng une ope sl o0 WHS”