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Form D-VH Forel alles UNITED states COMFUGHTO*FCe ‘DVH 0290 ‘BATE OF REGISTRATIONPUBLICATION wenn 04 ow 7 vou 06 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 315 SCR SPORT CRUISER Py) Wha the ype or svle of the design for which registration sought? FIBERGLASS SPORT CRUISER {]y} Provide a brief general statement setting forth the salient features of the design. DESIGN\' OVERALL APPEARANCE INCLUDING DECK LAYOUT, HULL CONFIGURATION ‘AND SHAPE Orcheck nare it fealetering | | If this design is derived rom an ear design, describe how that design has been revised, ape or earranged. sign.» N/A Use Form 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 ofthe design is difficult ‘or impossible to ascribe, DESIGNER(S) _¥I Please check here if those conditions are satisfied and you are providing the employer's name. Name;___CROWNLINE BOATS, INC. — 11884 COUNTRY CLUB ROAD WEST FRANKFORT, IL 62896 Address: Address: If the owner is different from the designer(s) or employer named above, provide the name and address of the owner: a Name: OWNER, Tenor Adress: DESIGNERS) ge __ Wesanapplication for registration ofthis design dented | Tf yes, identify the county and date of application: = Sey (<0) in an application filed in a foreign country that extends to \') Country: aD designs of owners who are citizens ofthe United States, or Priorrry © PeSons fling applications inthe United States, similar Date of application: —___ protection to that afforded in 17 USC. chapter 13? a yes @No Serial No: ‘Was this design made public before the date of application? @ Yes Q No 5 "APPLICATION RECEIVED * o ifyeson what due? __ SEPTEMBER 20, 2005 fe § UEC M320 bees Dar var mua quae reuse MORE ON BACK ‘aca (eae siete Bo nor wre eke EXAMINED BY Tee FORM D-VH CHECKED BY FOR ‘CORRESPONDENCE COPYRIGHT ayes OFFICE USE, ‘ONLY D0 NOT WRITE ABOVE THIS LINE. IF YOU NEED MORE SPACE, USE & SEPARATE CONTINUATION SHEET. (Form D-VHIGON) ; Please provide the name and address ofthe person to whom correspondence regarding this application may be directed: : KEVIN J. RIEM ; Name: _ CONTACT gases; _11884 COUNTRY CLUB ROAD PERSON WEST FRANKFORT, IL 62896 mail address _KTLE@ 5 FAX number__(618) 932-8746 Dastin pone: 618 ) 937-6426 oy Give the name and account number the gistration fei tobe charged toa Deposit Account established in the Copyright Office: A Name of Account: DEPOSIT Account number: ACCOUNT " DECLARATION: The undersigned, asthe applicant or the applicants duly appointed agent or representative, being hereby wamed 1 4 that willful false statements are punishable by fine or imprisonment, or both, under 18 U.S.C. $1001, and that such willful false aa statements may jeopardize the validity ofthis application orany resulting registration, hereby declare tothebestof his orherknowledge and belief: (1) thatthe design has been fixed in a useful article; (2) thatthe 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) thatthe design has not previously been registered on behalf ofthe applicant or applicant’s predecessor in ttle; and (5) that the applicant isthe person entitled to protection and to registration under chapter 13 of ttle 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", 2005, CROWNLINE BOATS, INC ‘Where on the useful article is the design notice located? PORT AFT EXTERIOR CERTIFICATION AND SWORN STATEMENTS Heteun -\ + 1-3 applicant, he or she is properly authorized to execute this application ga behalf ofthe applicant. Te. DPS ne — WAS ifexresinamncen PHSMRTN 61g) 937-6426 (618) 932-8746 eT — Toa RT ar Saar er cet hte an Ruck meee CS Let) Cortticate — a Taal in CROWNLINE BOATS, INC. ATIN:KEVIN J. RIEM window Tomsaiivewiso® Paeneneer, Se tueued 11884 COUNTRY CLUB ROAD pene gore anced address: cygaezey WEST FRANKFORT, IL 62896 eit epee = ‘atin, De onze 1980 17 U8 $127. Panay oats raprnarnton incor wnoninpy mates af pera matey afacg i acai nde cco be pypese of cing ston ta ign uni Cae Saya pry te asa dora nr an 8100, an ey Hs Peps a ns ay Ree ae eg ones he capes be eta, Javay 2002—nak Web Ra aru 2008. Pie on moje paper US Gomes Png OMe: 0005 DVH 0290