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ee FORM D-VH | - RRR corre REGISTRATION NUMBER, 1 ‘DUH 0167 ‘SATE OF REGISTRATION PUBLICATION Nov. 17, 2003 ery oor vee 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. CROWNLINE 260EX DECKBOAT ee AW Me AN CAME AIRE MATT RAEN BOS A ARS TEEN, BOO AIR a ‘What is the type or style of the design for which registration is sought? PIRERGLASS DECKEOAT Provide a brief general statement setting forth the salient features of the design. _OVERALL APPEARANCE INCLUDING DECK LAYOUT, HULL CONFIGURATION AND SHAPE. Ce cet feceting'/.fthis design is derived from an earlier design, describe how that design has been revised, adapted, or reaanged. eee sean N/A BAvWCON for adsitonel 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 made within the regular scope of employment of the designer(s) and (2) te individual authorship ofthe design is dificult Cor impossible to ascribe, DESIGNERG) _& Please check here if those conditions are satisfied and you are providing the employer's name. Name: CROWNLINE BOATS, ING. Name: Address:_11884 COUNTRY CLUB ROAD Address: -WEST_FRANKFORT, IL. 62896 __ ‘the owner is different from the designer(s) or employer named above, provide the name and address ofthe owner: Name: OWNER, IFNOT ‘ DESIGNERS) “rrr asm aplication for opisuation ofthis design identified) Ifye, identify the county and date of application: ES © < > imam application fled in a foreign county that extends to |! Country: » designs of owners who are citizens ofthe United State, ot to persons filing applications in the United States, similar ‘Date of application: PRIORITY protection to that afforded in 17 U.S.C. chapter 13? CLAIM yes ENo Serial No: —________ ‘Was this design made public before the date of application? &@ Yes Q No ey ‘seeucaTionneceveNOV - 3 2003. If yea, on what date? fy cemmcore cen, SPPTEMRER 3 ———2003 4 DATE MADE ” i punpanmoenen Nov 03 2003 PUBLIC 8 DO Nor Ware HERE Page tot page MORE ON BACK EXAMINED I 57, ld FORM D-VH CHECKED By — TORRESEN ———— ron ‘CORRESPONDENCE ‘coPYAIGHT aves: OFFICE ne OF “WEST FRANKEORT, IL. 62896 saat address FAX number 618-932-8746 fy Geena a Suwanee DEPOSIT Account number: Aaccounr “unt num! DECLARATION: The undersigned, as the applicant ox the. Spplicant’s duly appointed agent or representative, being hereby warned {at wilful faloe statements are punishable by fine or imprisonment, ot Eo ee ne oe USC. §1001, and that such wilful false andbaieg Smdeetevaltiyettisaplcasonoran esate gssion hen deiestchesatierte ae Complete if applicable: Fenian as been made public with a design notice as prescribed by 17 USC $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 Kocated?” PORT AFT EXTERIOR Ox, eg tisfox CERTIFICATION AND SWORN STATEMENTS "sues 7. ctaxron : _ __ PRESIDENT Fano cine aso ori - aamraneO48)-937-6426 £618) 932-8746 raf Copyright Office fees are subject to change. For current fees, check the nes Me DERN window axeeinnsne — envelope 2 Nee ne cc cr mney ote peyase to this 11884 COUNTRY CLUB ROAD