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FORM D-VH For Vessol Hull Desi UNITED STATES COPYRIGHT OFFICE REGISTRATION NUMBER DUH 0165 [BATE OF REGISTRATIONPUBLICATION mon NOVe 17, 2003 DO NOT WRITE ABOVE THIS LINE. IF YOU NEED MORE SPACE, USE A SEPARATE CONTINUATION SHEET. (Form D-VH/CON) so OS a nTE (Anioemsiseetscncsnessneean CET PATER ANN ARH < Please give the make and model of the vessel that embodies the design. CROWNLINE’ 206LS:.BOWRIDER// RUNABOUT. TITLE GP, Wins the type or style of the design for which registration is sought? ~ —< FIBERGLASS BOWRIDER oe 1b) | Provide a brief general statement setting forth the salient features of the design. E INCLUDING DECK LAYOUT, HULL CONFIGURATION AND SHAPE Boneck here it hiss a single fegeting If this design is derived from an earlier design, desribe how that design has been revised, adaped, of rearranged. fone design. ne desi N/A Provide the name and address of the designer(s). The name of the employer may be given instead of the designer(s) if, (1) the ‘design was made within the regular scope of employment ofthe designer(s) and (2)the individual authorship ofthe designis difficult or impossible to ascribe, % Please check here if those conditions are satisfied and you are provi ig the employer's name. ‘Name: CROWNLINE BOATS, INC. Name: ‘Address: 11884 co! -LUB Adress: -HEST_ FRANKFORT. IL. 62896 __ ifthe owner is different from the designer(s) or employer named above, provide the name and address ofthe owner: Name: OWNER, . Nor Address: 2 DESIGNERS) nS reresrnrenenrneetnrere ete ase Tee a ‘Was an aplication fr registration ofthis design identified |, If yes, identify the country and date of application: Be, in an application filed in a foreign country that extends to! Coumtry; — designs of owners who are citizens ofthe United States, or onrry ‘Peon filing applications in the United Stas, smar_ ‘Date of pplication; —___________ oe protection to that afforded in 17 U.S.C. chapter 13? CLAM Yes BINo Serial No: “Was this design made public before the date of application? &@ Yes Q) No Ey seruconrecenea NOY = 3-7} — tyes onwhatdate? ,SEPTENBER 5 2093 te vesien copies recerveNOV ~ 3 DATE MADE ie FUNDS RECEIVED Noy U3 2003 PUBLIC 5 MORE ON BACK hn ote se ONG WnTE Hehe Page tot pages EXAMINED BY, f 4 FORM D-VH_ ‘CHECKED BY —— ‘GORRESPONDENCE eee ayes OFFICE USE ' ‘ony DO NOT WRITE ABOVE THIS LIN "Please provide the name and address of the person to whom correspondence regarding this application may be directed: / Name: JAMES T. CLAXTON con 11884 COUNTRY CLUB ROAD _____ CONTACT dress: 1188 c aoe eee ee -MEST_FRANKFORT. IL 62896 __ Email address FAX number 618-932-8746 ___________ Daytime phone: ( 618 ) 93 4.26 Give the name and account number ifthe registration fee is tobe charged toa Deposit Accountestablished in the Copyright Office: © Name of Account: DEPOSIT Account number: ACCOUNT = = ey DECLARATION: The undersigned, as the applicant or the applicant's uly appointed agent or representative, being hereby warned hag ‘that willfl false statements are punishable by fine or imprisonment, or both, under 18 U.S.C. §1001, and that such willful false 8 statementsmay jeopardize the validity ofthis application orany resultingregistration, hereby declares othe bestofhisorherknowledge and belief: (1) that the design has been fixed in a useful article; (2) that the design is original and was created by the designer(s), or employer if applicable, named in the application; (3) that those aspects of the design for which registration is sought are not protected by a design patent (@) thatthe design has not previously been registered on behalf of the applicant or applicant's predecessor intitle; and (thatthe applicant is the person entitled to protection and to registration under chapter 13 of ile 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: ADHESIVE LABEL W/" PROTECTED DESIGN " 2003 CROWNLINE BOATS, INC. ‘Where on the useful article is the design notice located? PORT AFT EXTERIOR CERTIFICATION AND ‘SWORN STATEMENTS rrthe unsigned is not fhe antican hoo shes properly authorized to execu this application on behalf of the applicant. Ox tedster, _ ES T. CLAXTON \_ _ PRESIDENT. prrM(Gl) 927-6426 (618) 932-8746 _____— __ Mruieueeenos write the Copyright Office, Cortifieste [hasey Tnaleg mall in _CROWNLINE BOATS, INC. window ‘NumbecSreeAgt = envelope evar to this 11884 COUNTRY CLUB ROAD 3.Desgn material address: [ayammey SSS a WEST FRANKFORT, IL. 62896 ‘Yee Hl Regetraon 17 U6. $127 Pnaty or ae eprsenation."Whoera roving ana ersten matty cng eg calender i hag te pron of ning alan of PUSS Ser Eat Sopa evoyetaroe as 600 end ve an 6,50 ons ary ge page Pa nse ry have be Sune chap sal bt fo June 2062-20000 Web Ror Jeumy2ons Pret enya pat US. coveeent Pirg Oc: 0004 17