Date: --/--/---To

Dr. Amitendu Bhattacharya

Instructor-in-Charge
Course No. GS F241, Course Title: Creative Writing
Semester 2, Academic Year 2015-2016
BITS Pilani, K.K. Birla Goa Campus
Sir,
Sub: Declaration of Originality &Assignment of Copyright
I,
AbhasUpadhayay(2014A8PS518G)

(full name of author with ID No.), the copyright owner of the enclosed piece of creative writing
(poem/ short story/ creative non-fiction: tick the appropriate category), titled
______________________CHANDRAVATI__________________________________________
_____________,
do hereby declare that I am a registered participant of the course GS F241: CREATIVE
WRITING and that this is an original work submitted in partial fulfillment of the requirements
of the course. If on careful scrutiny you adjudge the above-said piece to be remarkable in style,
content and originality of thought, I authorize you to publish it under my name in any book/
anthology/ journal/ magazine of your choice.
I further state that:
1. This work does not infringe on the copyrights of others and does not contain any libelous
or unlawful statements.
2. Wherever required I have taken permission and acknowledged the original source.
3. The work has been submitted only to BITS Pilani and that it has not been previously
published or submitted elsewhere for publication either in part or whole.
I hereby permit you to edit, alter, modify and make changes in the work to make it suitable for
publication.
I hereby assign all the copyrights relating to the said work to the Instructor-in-Charge and BITS
Pilani University and affirm that I have not assigned any kind of rights of the work to any other
person or publications.
I agree to indemnify you and BITS Pilani University against any claim or action alleging facts,
which, if true, constitute a breach of any of the foregoing warranties.

Name

:Abhas Upadhayay

Signature