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Search Request Form TYPE OF WORK

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Search Request Form TYPE OF WORK Powered By Docstoc
					                                   Search Request Form


TYPE OF WORK:

[ ] Book [ ] Music [ ] Motion Picture [ ] Drama [ ] Sound Recording

[ ] Photography/Artwork [ ] Map [ ] Periodical [ ] Contribution

[ ] Computer Program [ ] Mask Work



SEARCH INFORMATION YOU REQUIRE:

[ ] Registration [ ] Renewal [ ] Assignment [ ] Address



SPECIFICS OF WORK TO BE SEARCHED:

Title: _____________

Author: __________________

Copyright claimant (if known): __________________(name in copyright notice)

Approximate year date of publication/creation: _____________

Registration number (if known): ________________

Other identifying information: __________________

If you need more space please attach additional pages.



Your name: _________________

Date: ___________

Address: __________________

Daytime telephone no.: ______________________

Convey results of estimate/research by telephone? [ ] Yes [ ] No
Fee Enclosed? [ ] Yes. Amount $_________ [ ] No

				
Work  Session Work Session Owner http://snurl.com/worksession
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