Copyright registration application

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

Registration application (postal)

Form F-01 V2.4

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

Contact details of the person registering the work

(Mr./Mrs. etc.)
We recommend that an email address or telephone number is given, in case of any questions regarding your work

About the work to be registered

Notes:

  • Please enter the copyright owner name(s) and title of work exactly as you wish them to appear on the registration certificate.
  • The ‘copyright owner’ should be the name of the person(s) or organisation that is the copyright owner of the work. For joint authorship this may be a collective name that you use or a list of names. If you use a pseudonym or pen-name, please also include your real name. i.e. Real Name, (‘Pen-name’).
  • The work title should be the name you use to refer to the item you are registering.
  • The ‘additional information’ field can be used to enter extra information to help you identify the items deposited - this information will appear on the schedule that accompanies the registration certificate.

Work 1

Please select the format that best describes your work.
One certificate is included in the fee, please indicate if others are required.

What are these?

Work 2

 If more than one work to be registered, please list below
Please select the format that best describes your work.
One certificate is included in the fee, please indicate if others are required.

Work 3

 For more than 3 works, please continue on separate forms(s)
Please select the format that best describes your work.
One certificate is included in the fee, please indicate if others are required.

Declaration

I hereby accept the terms and conditions, and certify that the information I have provided is correct and that the work to be registered does not infringe copyright or other rights of any other party.
 
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.

Please send completed form, copy of the work and payment to:

Copyright Witness - Registration Services

4 Tavistock Avenue

Didcot

Oxfordshire

OX11 8NA

United Kingdom

Please ensure you enclose a full copy of your work - not the original.

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