Certificates & Labels Order

When you have completed the form, please use the ‘Submit’ button at the foot of the page to confirm your details.

Certificates and labels order

Form F-11 V2.4

Fields in bold and marked with an asterisk ‘*’ are required and must be entered.

Your details

These details are used for security and your protection.
(Mr./Mrs. etc.)

Details of the work

Required items

Declaration

I hereby accept the terms and conditions and request that registered notice labels are issued for the work detailed above, and sent to the address specified on this form.
 
Applicants under 18 should also obtain signature from a parent or guardian:

Payment details

Paying by cheque of postal order

Please make cheques/postal orders/international money orders for UK Pounds Sterling (GBP), and made payable to ‘Copyright Witness’.

Paying by credit/debit card

(tick one)

Visa Credit Mastercard Visa Debit 

UK Maestro American Express 

(name exactly as it appears on the card)

 

 

(if shown)

 

 

 

 

(must be entered if it appears on your card, otherwise leave blank)

 

 

(3 or 4 digit code, normally found on signature strip)

 

 

(leave blank if not applicable)

 

Postal address including postal/ZIP code

 

 

 

We recommend that an email address or telephone number is given, in case of any problem regarding payment.

certlabels-sendto

Copyright Witness - Registration Services

4 Tavistock Avenue

Didcot

Oxfordshire

OX11 8NA

United Kingdom

The prices quoted on this form are valid until the end of June 2017. After this time please visit our web site at www.copyrightwitness.com to obtain a valid application form.