You are on page 1of 5
Form D-VH DUH 0316 ‘DATE OF REGISTRATIONPUBLICATION seam 06 coy 26 vou 06 DO NOT WRITE ABOVE THIS LINE. IF YOU NEED MORE SPACE, USE A SEPARATE CONTINUATION SHEET. (Form D-VH/CON) lease give the make and model of the vessel that embodies the design. Ultra Cat 25x TITLE _ 9 (a) WRRta ep ace fhe design fer which rpenon suse Shallow draft recreational fishing boat (b) Provide a bref eeneral semen seing forth he salient feats ofthe design ; DESIGN Channel that runs the length of the boat from the bow region Gloneortet “through to the transom recess for an outboard motor 2 a angle ms design check here it SESE (:) Wiis designs dvved fom an eats design, descibe how tat design as been revised, adapted, orearanged tne design. N/A __ —_ Divaicon for adetional NEE ESE a gu TE PaNNTETETE TEETER TEP ENSEETETE TEER TEPER SEER TEER s 4 Provide the name and address of the designer(s). The name of the employer may be given instead ofthe 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 i difficult ‘or impossible to ascribe, DESIGNER(S) 4 Please check here if those conditions are satisfied and you are providing the employers name. Ndbktra Cat L.L.c. ss Name:_Joe@1 Buton ‘Address:P+0. Box 39 ‘Address: 0+ BOX 39 Hamlin, Texas _79520_ Hamlin, Te If the owner is different from the designer(s) or employer named above, provide the name and address of the owner: ‘Name: — = OWNER, IFNOT DESIGNERS) in an application fled in a foreign country that extends 10 Country: sassnessiiesTetiaes designs of owners who are citizens of the United States, or 5 (a) ‘Was an application for registration of this design identified (b) If yes, identify the country and date of application: Perorrry (© Persons filing aplicasons inthe United Stats, similar Date of application: — protection to that afforded in 17 U.S.C. chapter 13? CLAIM Byes No Serial No: ‘Was this design made public before the date of application¥2 Yes Q) No ey ‘APPLICATION RECEIVED eyes, on what date? July 4, 2005 _ Fe Nae) DATE MADE Re FUNDS RECEIVED - PUBLIC 3 MORE ON BACK scorpio spices ore EXAMINED BY - "FORM D-VH J, CHECKED BY ton ‘CORRESPONDENCE COPYRIGHT ayes ‘OFFICE USE ONLY DO NOT WRITE ABOVE THIS LINE. IF YOU NEED MORE SPACE, USE A SEPARATE CONTINUATION SHEET, (Form DVICON) naa, 7 Please provide the name and address ofthe person to whom correspondence regarding this application may be directed: Name; Tim Cook —__— —__—- — Box 10107 CONTACT oe Address: ? +O. Liberty, Texas _77575_ FAX number936_33: : Give thename and account number i the registration fee isto be charged toa Deposit Account established in the Copyright Office: Name of Account: ee _ DEPOSIT Account number: ACCOUNT — a DECLARATION: The undersigned, asthe applicant o the applicant's duly appointed agent or representative, being hereby wamed that willful fase 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 declares tothe best ofhis orher knowledge and belie: ‘() that the design has been fixed in a useful article; () that the design is original and was created by the designer(s), or employer if applicable, named in the application; {@) that those aspects ofthe design for which registration is sought are not protected by a design patent; (G4) that the design has not previously been registered on behalf of the applicant or applicant's predecessor intitle; and (5) 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 is the exact form of the design notice: Design Protected 2005 Ultra Cat LLC _ Where on the useful article is the design notice located? Starboard side of transom CERTIFICATION AND SWORN STATEMENTS Ifthe undersionadieno thaanntic he or she is properly authorized to execute this application on behalf of the applicant. a , 21 November 2005 _ Sane > ae Tim Cook _ Counsel _ Fanrarhponane ae 936 336 8200 936 336 8203 “eos rer Pa al sae Copyright Office fees are subject to change. For current fees, Rute ae RC cea Certificate will be ‘malled in window envelope or cg unr ths capa shal 2a analy ont ase an 650 armor an S050, en ey iso ogee Pa haael ay ave new Gen woe is tape Stal oa” DVH 0316 23, NOV 25 2005 cooler