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| Form D-VH Ghar srs cortnann omce Die 0340 DATE OF REGISTRATIONFUBUICATION 3 B Cy ont Day vow 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. Majek 226 Illusion - TITLE = — Whats ete or of he eng or WHER FeaTationsSough™ (a) "Shallow Water/lats Recreational Fishing Boat Provides brief general statement seting for the salient features of he design pesicn(b) . : ® Catamaran V shape appearance with flat bottom tunnel. Catamaran appearance holds and forces water under boat and towards tunnel. Outer Catamaran includes three water releases running length of hull. ‘oi (c)_ Mths design's derived from an eater design, describe how that design has ben reise, adapted, o rearranged Sno gos, te Form onwcon for eionl —- 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 employmentofthe designers) and (2) the individual authorskipof the designis dificult orimpossible to ascribe, DESIGNERS) © Please check here if those conditions ae satisfied and you are providing the employer's name. Name: __John Majek III Name; __James Maiek ‘Address:_7001 Road P_________Address:_7001 Road P Rodd Field Villiage —__ Rodd Field Villiage —Corpus Christi, TX 78418 Corpus Christi, TX 7841 If the owner is different from the designer(s) or employer named above, provide the name and address of the owner: Name: — OWNER, IFNOT Address: ———— DESIGNERS) . ae in an application filed in a foreign country that extends vo (0) Country: » designs of owners who are citizens of the United Sites, ot to persons fling applications in the United States, similar ‘Date of application: Letts protection to that afforded in 17 USC chapter 13? coe Oyes QNo Serial No: 5 (a) OO EET Was this design made public before the date of application? 9 Yes OQ) No by AppUCATION AEcEED NN TM ENON iryesson what da May 8, 2006_ _ i oesion cons acceMAR 1 6 ‘07 DATE MADE fe FUNDS RECEIVED 7 PUBLIC ig Erase ees See MORE ON BACK EXAMINED BY iS; rom Da CHECKED EY a ere rR, ‘SORRESPONDENCE connate ayes OFFICE USE only . }OVE THIS LINE. IF YOU NEED MORE SPACE, USE A SEPARATE CONTINUATION SHEET. (Form DVHVCON) Name: __James Majek 7 o Please provide the name and address of the person to whom correspondence regarding this application may be directed: CONTACT ajress; _ 7002 Road P, Rodd Field Village PERSON e - aoe Corpus Christi, Texas 78418 Email address _Maiekboats@le-usa.net FAX number. — Daytime phone: ( 361 )_991-3102 8 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, as the applicant or the applicant's duly appointed agent or representative, being hereby warned be that willful false statements are punishable by fine or imprisonment, or both, under 18 USC §1001, and that such willful false state- ‘ments may jeopardize the validity ofthis application or any resulting registration, hereby declares to the best of hs or her knowledge and belief (1) that the design has been fixed ina useful a (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 ane not protected by a design patent; (4) that the design has not previously been registered on behalf ofthe applicant or applicant’ predecessor in ttle; and (5) that the applicant isthe 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 USC §1306. Following is the exact form of the design notice: _ Protected Design 2006 Majek Boatworks In ‘Where on the useful article is the design noice located? Starboard Side of Transom CERTIFICATION AND ‘SWORN STATEMENTS If the undersigned is not the applicant, he or she is properly authorized to execute this application on behalf of the applicant. a ad RON Vice President _ majekboats@lc-usa,net Cerne write the C rene 3000. Certificate fTanew - will be maiiedin |___David E. Harris _ _ Window” | Raniasrmer® oo ome” 802. N. Caraneahua #900 dress: i — Corpus Christi, Texas 78470 Set neato 1 td ER ee aE RNREN Tk lai acing en eal tn i caps pes ang ages a Sage wih che bapa ete an 20 an et ae er Oey tera pasa ah mayhem ahve eral alse