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FORM D-VH @ For Voss Hull Design UNITED STATES COPYRIGHT OFFICE REGISTRATION NUMBER DVH 0217 TATE OF REGISTAATIONPUBLICATION 4 22 05 DO NOT WRITE ABOVE THIS LINE. IF YOU NEED MORE SPACE, USE A SEPARATE CONTINUATION SHEET, (Formn D-VHICON) ‘Please give the make and model of the vessel that embodies the design. -CHAPARRAL SSi 256 TITLE ( ‘What is the or style of the design for which reg is s¢ : ) a) “FIBERGLASS MONO-HULL OPEN BOW SPORT BOAT (b) Provide a brief general statement setting forth the salient features of the design. i and configuration, hull confi and style lines DESIGN for adational 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 of the designer(s) and (2) the individual authorship of the design is difficult ‘or impossible to ascribe. _ . . DESIGNERG) 0 Please check here if those conditions are satisfied and you are providing the employer's name. Name: _ Chaparral Boats, Inc. Name:_Phares and Associates Address P. O. Drawer 928 Adiress: 33228 W. 12 Mile Rd. Suite 317 300 Industrial Park Blvd. Farmington Hills, MI 48334 Nashville, GA 31639-0928 If the owner is different from the designer(s) or employer named above, provide the name and address of the owner: Chaparral Boats, Inc. OWNE! myer " om Paar Blvd. DESIGNERS) = —Nashville. GA 31639-0928 ___ 5 ( ‘Was an application for registration of this design identified (b) ‘Tf yes, identify the country and date of applicati in an application filed in a foreign country that extends to designs of owners who are citizens ofthe United States, or 0 to persons filing applications in the United States, similar Date of application: PRIORITY protection to that afforded in 17 U.S.C. chapter 13? cual Qyes No Serial No; ‘Was this design made public before the date of application? @ Yes Cl No fy APPLICATION RECEN y i oorsnecena_ HH 26.200 If yes, on what date’ 8 2003 fy ac pesioncomesreceven MAN 26. 2005 Bs j spe ene ence one pase MORE ON BACK > corps apna lhe tom af ancon’, Paw tel pager . MINED B *"Date in space 6 and certification confirmea "NPY 7749 FORM DWH by CO by authority telephone call to remitter, CHECKEDBY. 4/19/2005." FOR CORRESPONDENCE corn Rar ayes OFFICE USE ony DONOT WRITE ABOVE THIS LINE. IE YOUNEED MORE SPACE, USE A SEPARATE CONTINUATION SHEET. rom BVNICON "Please provide the name and address of the person to whom correspondence regarding this application may be directed: / Name: __William S. Pegg conracr. . P.O. Drawer 928 PERSON eos Nashville, GA_31639-0928 E-mail address DPega@chaparralboats.com FAX number (229) 686-3660. Daytime phone: ( 229 ) 686-7481 Give the name and account number if the registration fee is to be charged to.a Deposit Account established in the Copyright Office: ‘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 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 resulting registration, hereby declares to the best of his/her 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; {G) 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 in title; and (5) thatthe applicant isthe person entitled to protection and to registration under chapter 13 of tle 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. lowing is # f design notice: Following i hg c*afipical dtnclve Owner entiation, with "Protected Design” ‘across the top, and "2003" actoss the bottom ‘Where on the useful article isthe design notice located? Aft port quarter. ——— Ifthe 1mAercionod ie nat the annlicant. he/she is property authorized to execute this application on behalf of the applicant, * CERTIFICATION AND SWORN STATEMENTS QXy OPS OF Xone oe William S. Pegg Vice President ri orp rae Poston Tie > (220) 686-7481 (229) 686-3660 bpegg@chaparralboats.com ‘elphane number FAC rinber mal eos PRU oe ce ee ek aR eC ce Copyright Office Website at http:/vww.loc.gov/copyright, or call (202) 707-3000. Mail Name one Chaparral Boats, Inc. Tanne witb P. O. Drawer 928 mailed in cise ¥ Slope Nashville, GA_31639-0928 ‘ go, 200241380 ‘SFUsar iar Penay forse epresartaton Where keeigy rakes afasereeersior sonal fecta Pe ove evonate nar ts capil De puyen craig ngetaion cra ‘gn ender is halal py ofa tne an $00 an ne mre han 90 andy Ho logon tha ea may Rave me el eee hap al ened” Samay 196-90 000, ‘Qronconenrome "20'S GOVERNMENT PRINTING OFFICE: | OVERHEAD s = a