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Form D-VH DVH 0309 BATE OF REGISTRATIONPUBLICATION worth 06 cay 02 your 06 pacman DONOT WRITE ABOVE THIS LINE. If YOU NEED MORE SPACE, USE A SEPARATE CONTINUATION SHEET. (Form D-VHICON) Please give the make and model of the vessel that embodies the design. CROWNLINE 226LS BOWRIDER TITLE 9 (1) What's he type or styl ofthe design for which registration is sought? |) Provide a brief general statement setting forth the salient features ofthe design. DESIGN\'") oveRALL APPEARANCE INCLUDING DECK LAYOUT, HULL CONFIGURATION AND SHAPE If this design is derived from an earlier design, describe how that design has been revised, adapted, or rearranged. N/A for asétonal VE cn eens RRM Oe SH ANNAN NORE SSN ee ee 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 designs difficult 4¢ impossible to ascribe. 20) Please check here if those conditions are satisfied and you are providing the employer's name. ‘Name: CROWNLINE BOATS, INC. ‘Name: ‘Address: 11884 COUNTRY CLUB_ ROAD Address: WEST FRANKFORT, IL 62896 vi nthe owner is different from the designer(s) or employer named above, provide the name and address of the owner: ‘ Name: OWNER, . DNor’ Adare: DESIGNERS) If yes, identify the country and date of application: ron,” Wasan application for registration ofthis design identified ‘Lrg (1) iman application filed in a foreign country tat extends to \'?) Country: A+] esigns of owners who are citizens ofthe United States, or priorrry ‘9 Pes0ns fling applications inthe United States, similar Date of application: protection to that afforded in 17 U.S.C. chapter 13? cane QyYes @No Serial No ou ‘Was this design made public before the date of application? & Yes Q No ie i Soe aj If yes, on what date? AUGUST 2 __2004_ DATE MADE " . PUBLIC woe Gn bck aa a gr a aay a pee eraar eRe 0 a ae ae itt cote reget pet EXAMINED EF. CHECKED ————————————— eon ‘GORRESPONDENCE coPYAIGHT ae OFFICE USE, OnLy vonBONOT WRITE ABOVE THIS LINE. IF YOU NEED MORE SPACE, USE A SEPARATE CONTINUATION SHEET. (Form 0.VHIGON). my ‘Please provide the name and address ofthe person to whom correspondence regarding this application may be directed KEVIN J. RIEM ! Name: _ oo CONTACT vss; 11884 COUNTRY CLUB ROAD person “re a — WEST FRANKFORT, IL 62896 __ Email address KT4em@crownline.com_ FAX number 018793276916 Daytime phone: (618) 9: 3 Give the name and account number ifthe registration fee i to be charged to Deposit Account established in the Copyright Office: Name of Account: —___ DEPOSIT Account number: 9 DECLARATION: The undersigned, asthe applicantor the applicant’ 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 ofthis application or any resulting registration, hereby declares tothe best ofhisorherknowledge and belief: (CU) that the design has been fixed ina useful article; (2) that the design is original and was created by the designer(s), or employer if applicable, named inthe 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 intitle; and (S) that the applicant i the 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 isthe exact form of the design notice: ADHESIVE LABEL W/"PROTECTED DESIGN" 2004 CROWNLINE BOATS, INC. CERTIFICATION AND SWORN STATEMENTS ‘Where on the useful article is the design notice located? " ___PORT AFT EXTERIOR _ Ifthe undenienssrsfsbe applicant, he or she is properly authorized to execute this vy tog on behalf ofthe applicant Ye a VICE¢PRESIDENT & GENERAL MANAGER Postin«T (618) 932-6916 kriem@ Line. to change. For currer er a CROWNLINE BOATS, INC. ATTN: window ‘NurberSteevAgt ¥ Apples envelope Gisela nanometre on ebe to thie 11884 COUNTRY CLUB ROAD Booger 7 address: Syauaaey —— ——| {bse Hut Repataon January 209 WHO vay 2089 @ Pra need paper 1S cavermant Peng Of: 2003