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 COPYRIGHT APPLICATION FORM
This is a secure form

Complete each field and move from field to field with the tab key.  Do not hit enter because that will submit the form.  Each field indicated with an * is required.

Section 1: Contact Information

Title
First Name *
Last Name *
Middle Initial
Company
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
Fax Number
E-mail *
URL

Section 2: State the title and previous or alternative title(s) of the work (if any).

Title

Previous or Alternative Title(s)

Section 3: In What Year was the Work Created?

Year

Section 4: State the name(s), citizenship(s) and date(s) of birth for the creator(s) of the work.

Author #1

Name
Citizenship
Date of Birth 

Author #2 

Name
Citizenship
Date of Birth

Section 5: Identify the nature of each author's contributions to the work.

Author #1

Author #2

Section 6: If you are not the author of the work but you are
claiming copyright, briefly state the basis of your claim.

Section 7: Is your work is based on any pre-existing material or does it include any pre-existing material?  If so, identify the pre-existing material and explain how your work differs.

Pre-existing material

Difference from your work

Section 8: If the material has been published or publicly distributed, please give the date of the first publication or earliest distribution and the nation of the first publication or earliest distribution.

Date of first publication or earliest distribution

Section 9: Was the work created in the course of employment? If so, explain.

Section 10: Has this material, or an earlier version, been previously registered in the Copyright Office? If so, explain.

Previous Registration Number

Year of Previous Registration

Section 11: Please send us four (4) copies of your work, either by:

a. Email attachment to PIPLPC; or
b. Fax to 703-549-3111; or
c. Mail to:
PRAVEL INTELLECTUAL
PROPERTY LAW, P.C.
1800 Diagonal Road, Suite 600
Alexandria, Virginia 22314 USA

d. Send us a file (pdf, tif or jpg file format) (maximum file size 2.0gb). Send the file to us when you receive the confirmation that we have received your copyright application form.  Instructions will be self-explanatory.

Application Type:

Legal Fee including Costs:

Application for Copyright Registration (completed in approximately 10-14 business days)

$330

Expedited Application for Copyright Registration (completed in approximately 3 - 5 business days)

$565

Section 12: Payment Information

Credit Card Number:
Expiration Date (mm/dd/yyyy)
Name On Card:

Please note that unless payment is received with your Request, and you are accepted as a client, an Attorney-Client Relationship will not be created.

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