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Form D-VH tmen ares concur orice DVH. 0230 BATE OF REGISTRATIONPUBLICATION worth 05 pay 04 vou 05 =___.00 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 gf the vessel that embodies the desi Blac 2s WR (We vy TITLE = — 9 (a) PRE caper Qheek rere it is tea ingle esign. Ocheck nere fm x(b) Por BH ay ee , describe 2 ‘fein has be fea sine or rearranged, 3 Provide the name and address of the designer(s). The name of the employer may be given instead of the designer(s) if, (I) the design was made within the regular scope of employment of the designer(s) and (2) the individual authorship ofthe designis difficult ‘or impossible to ascribe. DESIGNER(S) © Please check here if those conditions are satisfied and you are providing the employer's name. Name: _“Dyslasly Bowe, ne Name: Address:_2US” U (Abe Address: = “Pid. “Box — — If the owner is different from the designer(s) or employer named above, provide the name and address of the owner: Name; OWNER, IF NOT DESIGNERS) ‘)_ Wasan application for registration ofthis design identified })) If yes, identify the country and date of applicat (a) jin an application filed in a foreign country that extends to Country: — designs of owners who are citizens ofthe 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? cua Qyes QNo Serial No: le APPLICATION RECEIVED Ei ccxcncoMAR. 2 2005 22005 HAR O 2 cons 6 I yes, on what date? 0 2a. DATE MADE RE FUNDS AECEIVED. PUBLIC i 1 Scodatioginauctora, "Sgn Be tom etctan MORE ON BACK Page tet panos EXAMINED BI FORM D-VH GRECKED BY - CORRESPONDENGE FOR ‘CORRESPONDENCE Conan ayes OFFICE USE. ONLY DO NOT WRITE ABOVE THIS LINE. IF YOU NEED MORE SPACE, USE A SEPARATE CONTINUATION SHEET. (Form D-VHICOR 7 Please provide the name and address of the person to whom correspondence regarding this application may be directed: Name: Boye Yaclocorsa a CONTACT pairs as. a 3 ——_______ uc mat aiess fash agl @ placa FAX number 280-789 - Daytime phone: fe ) 739. 4k2—___ e507 DC EES EAE ane 8 Give the name and account number if the registration feeis to be charged to a Deposit Account established in the Copyright Office: Name of Account: DEPOSIT Account number: ACCOUNT sc eT SESSA eit 9 DECLARATION: The undersigned, as the applicant or the applicant's duly appointed agent or representative, being hereby warmed 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 ofthis application orany resulting registration, hereby declaresto the best of his orher knowledge and belief: (1) that the design has been fixed in a useful article; (Q) thatthe design is original and was created by the designer(s), or employer if applicable, named in the application; () that those aspects of the 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 intitle; and (6) that the applicant is the 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 isthe exact form of the design notice: CERTIFICATION AND SWORN STATEMENTS Where on the useful article is the design notice located? On Artaleon net to seral damber If - -~-tersigned i: * ¢ the applicaa properly authorized to execute this application on behalf ofthe applicant. Cue Mihurhed rk ice eee Tce ee i ten ie Certieste hana = EEE Saran | DYNMGY “Pos, (ae oo window | abeiSeetlgi¥ Sa "DS Ub Hghdey 34 oa SFOS siaer Porat forfse repression shone tnonngy a yafocing hi te sae ue’ ie Super epurpos suing egarabon = Sein ders Goa by ape elias an $50 and mar han 1500s an gt cage ate may Me a oa sete capes ba ote ray 200-ean Web Ra Jani 2009. @ Pred ney per US Govurment iting OMe 202300 PVH 0230