Copyright Questionnaire

Name *
Phone *
Business entity types include "individual", "partnership", "LLC", and "corporation".
Select one
For example, "instructional DVD", "musical recording on CD", "lithographic print".
If yes, please describe (a) the circumstances under which it occurred and (b) provide the date (MM/DD/YYYY) and location when this first happened. If no, write "no".
Someone who is anonymous cannot be identified by name at all. Someone using a pseudonym is using false name.
If yes, what is each author responsible for? For example, "author 1, graphics; Author 2, words." If no, write "no.
If the copyright owner is different from the author of the work, please explain how ownership was obtained. For example, "copyright was assigned," "author is the employee of the copyright owner," etc.
If yes, what is the Registration Number and date of registration? Why is another registration being sought? If no, write "no"
If yes, how does this work differ from the preexisting work(s). For example, "it's sculpture based on a drawing." If no, write "no".
If yes, please describe this collection. For example, "a compilation of 19th century political cartoons." If no, write "no".
When was this work completed? *
When was this work completed?