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FORM D-VH For Vessel Hull Dosi UNITED STATES COPYRIGHT OFFICE ‘REGISTRATION NUMBER DUH 0161 ‘BATE OF REGISTRATONPUBLICATION Oct. 27, 2003 DO NOT WRITE ABOVE THIS LINE. IF YOU NEED MORE SPACE, USE A SEPARATE CONTINUATION SHEET. (Form D-VH/CON) Please give the make and model of the vessel that embodies the design. “Grestiner 1400 Angler TITLE — —— (a) RRRLIDe peor se fe design for which egsraon sought? Provide « brief general statement setting forth the salient features of the design. peston(b Overall i thetic appearance hull configuration (c) tis. desiens derived from an eater design, deseribe how that design has been revised, adapted, or rearranged, fre soson Des te fom = = Diicon _ _ for acatonal jane Provide the name and address of the designer(s). The name of the employer may be given instead of the designen() if, (1) the , APPLICATION RECEIVED Was hs sign made publi before he te apna? @ Yes @ Noy Than If yes, on what date? “MY a {AlCl et LOG DATE MADE PUBLIC sneer ae MORE ON BACK; Sonpelesl apple Spr fe tm of secton 8 te ome EXAMINED BY A. FORM D-VH CHECKED BY CORRESPON FOR ee COPYRIGHT aves OFFICE USE only DONO WRITE ABOVE THIS LINE. IF YOU NEED MORE SPACE, USE A SEPAHATE CONTINUATION SHEET, (fom DVNCON_________ Please provide the name and address of the person to whom correspondence regarding this application may be directed: / Name: Davié6. Schatz - — CONTACT adress: PERSON, a Street Minneapolis, MN_58402 Email address : Daytime phone: ( 612 ) 3964017. Give the name and account number if the registration fee is tobe charged to a Deposit Account established in the Copyright Office: Name of Account: DEPOSIT. Account number: ACCOUNT ——— — DECLARATION: The undersigned, us the applicant or the applicant's duly appointed agent or representative, being hereby warned 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 ofthisapplication orany resulting registration, hereby declarestothebestofis orher kneswledge and belief: (J) that the design has been fixed in a useful article; (2) thatthe design is original and was created by the designer(s), or employer if applicable, named in the application; {G) that those aspects ofthe design for which registration is sought are not protected by a design patent; () 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 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, CRESTLINER, INC., 2008 ‘Where on the useful article isthe design notice located’? wre unig ae come pate. (612.338.4817 812.332.9081 CERTIFICATION AND SWORN STATEMENTS ‘On transom beneath hull identification number wf ke ne che is properly authorized to execute this application on behalf of the applicant. David G. Schmatz NaroeSiosTnor® ‘Merchant & Gould P.C., 3200 IDS Center, 80 South Eighth Street Cosa envelope tothis address: 1 Aeetoue tn ein ceo mem ont sb MN 85402 “USEF Peray tors reprsnrntonranrr ner mane ogee cone corm hope'fo he papore tare operon rage snc Came ay spray tat $50 ana mere an 0, an any re rig aha Nave nt Gagne eset os raed”