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- FORM D-VH @ For Vessol Hull Design UNITED STATES COPYRIGHT OFFICE REGISTRATION NUMBER ‘DVH 0171 SATE OF REGTSTRATONPSUCATION Nov. 20, 2003 Mon by you 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 ofthe vessel that embodies the design, Triton Bass Boat Model x20 TITLE _— =~ wy What is the type or sive of the design for which repisualion is sought? (a) “MS Mottom ‘bass boat (fp) Provide a brief general statement setting forth the salient feature ofthe design DESIGN! new hull, new vortex pad surface on the hull, new console « “and seats, large casting decks and novel graphics. for ditional o ~ eslans 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 design is difficult impossible to ascribe. DESIGNER(S) Please check here if those conditions are satisfied and you are providing the employer's name. Name: Triton Boat Company, L.P. Name: Address: 15 Bluegrass Drive Address: Ashland City, TN 37015 Triton Boat Company, L.P. Name; Triton Boat Company, LP. 4 If the owner is different from the designer(s) or employer named above, provide the name and address of the owner: OWNER, 15 Bluegrass Drive _ Ashland City, TN 37015 |), Wasan application for registration of this design identified (b If yes, identify the country and date of appl 5 (2) nan application filed ina foreign country tat extends to.) Country _ designs of owners who are citizens of the United States, or to persons filing applications in the United States, similar Date of application: —_ PRIORITY protection to that afforded in 17 U.S.C. chapter 13? Ce QyYes @No Serial No: — 6 iyes,onwhatdae JUNE _-15__—_—20¢ eg crscnconssnecene QUT i or . prea EYesosmsinma OCT 3 123 PUBLIC ey Pagetot pages EXAMINED BY’ iL ke ~ FORM D-H CHECKED BY —— — NI — im GRRRESPONDENCE poeeiaen Yes OFFICE Use ONLY DONOT WRITE ABOVE THIS LINE. IF YOU NEED MORE SPACE, USE A SEPARATE CONTINUATION SHEET. (Form D-VHICON) Soup Please provide the name and address of the person to whom correspondence regarding this application may be directed , Name: Andrew S. Neely, Luedeka, Neely & Graham, P.C. CONTACT ages: P20. Box 1871_ : : PE ~ Knoxville, 7 901 Email address AN@@1YELNG-patent.com _ FAX number (865) 523-4478 atime phone: (865 )_ 546-4305 eet ee Givethe name and account number ifthe registration feito be charged aDeposit Account established in he Copyright Offices ‘Name of Account: DEPOSIT Account number: ACCOUNT ~ ~— ~ onecnmetsemecmemamnacineemetera nse ene 9 DECLARATION: The undersigned, asthe applicant or the applicant's duly appointed agent or representative, being hereby wamed Ss 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 resutingregistration, hereby declares tothe best of his orher knowledge 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; (4) that the design has not previously been registered on behalf of the applicant or applicant's predecessor intitle; and (5) that the applicant isthe person entitled to protection and to registration under chapter 13 of tile 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: CERTIFICATION AND SWORN STATEMENTS ‘Where on the useful article is the design notice located? transom Ifthe undersigned is not the applicant, he or she is property authorized to execute this application on behalf ofthe applicant. Qy x Shae 7 1efe Q: S. Nee, Esq " Attorfey (B68) Sa6-4305 _ _TANSelyenwe-patent.com Tahara TF Sra Cortifeate [grey a oe wll be apices pa muisgin | Andrew S, Neely, Luedeka, Neely & Graham | ‘window “NunberiSiteetAat a ~ a ~ | maw den ar tis” | P.O, Box 1871 a eaperacw bo address: Gyiuiee¥ ~ i | Knoxville, TN 37901. Wee gp | singin 0. 2024158. ‘7S. giszr Penalty for ats representation. Voor knowgly makes aes preeraton nalyaflacing he its aairatie order ie chperotbetumoee al en eaten ‘rognander ts chap shat py gray nas he 300 a Pe ream 1,00, aay ws lgee Pains may haven hei une fis sat shal be oa ac tne 2002-20000 Wane ry 2003. @ Pit on els pape US covariant Preing Oe: 00048-4432, DUH 0171 OCT 2 9 2003 coPY__ K, Loprrigut oro