Filling Out Application Form PA

Detach and read these instructions before completing this form.

Make sure all applicable spaces have been filled in before you return this form.

BASIC INFORMATION
When to Use This Form: Use Form PA for registration of published or un- The Copyright Notice: For works first published on or after March 1, 1989,
published works of the performing arts. This class includes works prepared for the pur- the law provides that a copyright notice in a specified form “may be placed on all publicly
pose of being “performed” directly before an audience or indirectly “by means of any de- distributed copies from which the work can be visually perceived.” Use of the copyright
vice or process.” Works of the performing arts include: (1) musical works, including any notice is the responsibility of the copyright owner and does not require advance permis-
accompanying words; (2) dramatic works, including any accompanying music; (3) panto- sion from the Copyright Office. The required form of the notice for copies generally con-
mimes and choreographic works; and (4) motion pictures and other audiovisual works. sists of three elements: (1) the symbol “©”, or the word “Copyright,” or the abbreviation
“Copr.”; (2) the year of first publication; and (3) the name of the owner of copyright. For
Deposit to Accompany Application: An application for copyright example: “© 1995 Jane Cole.” The notice is to be affixed to the copies “in such manner
registration must be accompanied by a deposit consisting of copies or phonorecords rep- and location as to give reasonable notice of the claim of copyright.” Works first published
resenting the entire work for which registration is made. The following are the general prior to March 1, 1989, must carry the notice or risk loss of copyright protection.
deposit requirements as set forth in the statute: For information about requirements for works published before March 1, 1989, or other
copyright information, write: Information Section, LM-401, Copyright Office, Library of
Unpublished Work: Deposit one complete copy (or phonorecord). Congress, Washington, D.C. 20559-6000.

Published Work: Deposit two complete copies (or one phonorecord) of the best edition.

Work First Published Outside the United States: Deposit one complete copy (or
phonorecord) of the first foreign edition. PRIVACY ACT ADVISORY STATEMENT Required by the Privacy Act of 1974 (P.L. 93-579)
The authority for requesting this information is title 17, U.S.C., secs. 409 and 410. Furnishing the
Contribution to a Collective Work: Deposit one complete copy (or phonorecord) of requested information is voluntary. But if the information is not furnished, it may be necessary to
the best edition of the collective work. delay or refuse registration and you may not be entitled to certain relief, remedies, and benefits pro-
vided in chapters 4 and 5 of title 17, U.S.C.
Motion Pictures: Deposit both of the following: (1) a separate written description of the The principal uses of the requested information are the establishment and maintenance of a public
record and the examination of the application for compliance with legal requirements.
contents of the motion picture; and (2) for a published work, one complete copy of the Other routine uses include public inspection and copying, preparation of public indexes, prepara-
best edition of the motion picture; or, for an unpublished work, one complete copy of the tion of public catalogs of copyright registrations, and preparation of search reports upon request.
motion picture or identifying material. Identifying material may be either an audiorecor- NOTE: No other advisory statement will be given in connection with this application. Please keep
ding of the entire soundtrack or one frame enlargement or similar visual print from each this statement and refer to it if we communicate with you regarding this application.
10-minute segment.

LINE-BY-LINE INSTRUCTIONS
Please type or print using black ink.
What is a “Work Made for Hire”? A “work made for hire” is defined as: (1)

1 SPACE 1: Title “a work prepared by an employee within the scope of his or her employment”;
or (2) “a work specially ordered or commissioned for use as a contribution to a
collective work, as a part of a motion picture or other audiovisual work, as a
Title of This Work: Every work submitted for copyright registration must be translation, as a supplementary work, as a compilation, as an instructional text,
given a title to identify that particular work. If the copies or phonorecords of the work as a test, as answer material for a test, or as an atlas, if the parties expressly
bear a title (or an identifying phrase that could serve as a title), transcribe that word- agree in a written instrument signed by them that the work shall be considered
ing completely and exactly on the application. Indexing of the registration and future a work made for hire.” If you have checked “Yes” to indicate that the work
identification of the work will depend on the information you give here. If the work was “made for hire,” you must give the full legal name of the employer (or
you are registering is an entire “collective work” (such as a collection of plays or other person for whom the work was prepared). You may also include the
songs), give the overall title of the collection. If you are registering one or more indi- name of the employee along with the name of the employer (for example:
vidual contributions to a collective work, give the title of each contribution, followed “Elster Music Co., employer for hire of John Ferguson”).
by the title of the collection. For an unpublished collection, you may give the titles of
the individual works after the collection title. “Anonymous” or “Pseudonymous” Work: An author’s contribution to a
work is “anonymous” if that author is not identified on the copies or
Previous or Alternative Titles: Complete this space if there are any addi- phonorecords of the work. An author’s contribution to a work is “pseudony-
tional titles for the work under which someone searching for the registration mous” if that author is identified on the copies or phonorecords under a ficti-
might be likely to look, or under which a document pertaining to the work tious name. If the work is “anonymous” you may: (1) leave the line blank; or
might be recorded. (2) state “anonymous” on the line; or (3) reveal the author’s identity. If the
Nature of This Work: Briefly describe the general nature or character of the work is “pseudonymous” you may: (1) leave the line blank; or (2) give the
work being registered for copyright. Examples: “Music”; “Song Lyrics”; pseudonym and identify it as such (example: “Huntley Haverstock, pseud-
“Words and Music”; “Drama”; “Musical Play”; “Choreography”; “Panto- onym”); or (3) reveal the author’s name, making clear which is the real name
mime”; “Motion Picture”; “Audiovisual Work.” and which is the pseudonym (for example: “Judith Barton, whose pseudonym
is Madeline Elster”). However, the citizenship or domicile of the author must
be given in all cases.
2 SPACE 2: Author(s) Dates of Birth and Death: If the author is dead, the statute requires that the
year of death be included in the application unless the work is anonymous or
General Instructions: After reading these instructions, decide who are the pseudonymous. The author’s birth date is optional, but is useful as a form of
“authors” of this work for copyright purposes. Then, unless the work is a “col- identification. Leave this space blank if the author’s contribution was a “work
lective work,” give the requested information about every “author” who con- made for hire.”
tributed any appreciable amount of copyrightable matter to this version of the
work. If you need further space, request additional Continuation Sheets. In Author’s Nationality or Domicile: Give the country of which the author is
the case of a collective work, such as a songbook or a collection of plays, give a citizen, or the country in which the author is domiciled. Nationality or domi-
the information about the author of the collective work as a whole. cile must be given in all cases.
Name of Author: The fullest form of the author’s name should be given. Nature of Authorship: Give a brief general statement of the nature of this
Unless the work was “made for hire,” the individual who actually created the particular author’s contribution to the work. Examples: “Words”; “Coauthor
work is its “author.” In the case of a work made for hire, the statute provides of Music”; “Words and Music”; “Arrangement”; “Coauthor of Book and Lyr-
that “the employer or other person for whom the work was prepared is con- ics”; “Dramatization”; “Screen Play”; “Compilation and English Translation”;
sidered the author.” “Editorial Revisions.”
 Changed Version: If the work has been changed, and you are now seeking
3 SPACE 3: Creation and Publication registration to cover the additions or revisions, check the last box in space 5,
give the earlier registration number and date, and complete both parts of space
6 in accordance with the instructions below.
General Instructions: Do not confuse “creation” with “publication.” Every
application for copyright registration must state “the year in which creation of Previous Registration Number and Date: If more than one previous regis-
the work was completed.” Give the date and nation of first publication only if tration has been made for the work, give the number and date of the latest reg-
the work has been published. istration.
Creation: Under the statute, a work is “created” when it is fixed in a copy or
phonorecord for the first time. Where a work has been prepared over a period
of time, the part of the work existing in fixed form on a particular date consti-
tutes the created work on that date. The date you give here should be the year
6 SPACE 6: Derivative Work or Compilation
General Instructions: Complete space 6 if this work is a “changed version,”
in which the author completed the particular version for which registration is
“compilation,” or “derivative work,” and if it incorporates one or more earlier
now being sought, even if other versions exist or if further changes or additions
works that have already been published or registered for copyright or that have
are planned.
fallen into the public domain. A “compilation” is defined as “a work formed
Publication: The statute defines “publication” as “the distribution of copies by the collection and assembling of preexisting materials or of data that are
or phonorecords of a work to the public by sale or other transfer of ownership, selected, coordinated, or arranged in such a way that the resulting work as a
or by rental, lease, or lending”; a work is also “published” if there has been an whole constitutes an original work of authorship.” A “derivative work” is “a
“offering to distribute copies or phonorecords to a group of persons for pur- work based on one or more preexisting works.” Examples of derivative works
poses of further distribution, public performance, or public display.” Give the include musical arrangements, dramatizations, translations, abridgments, con-
full date (month, day, year) when, and the country where, publication first densations, motion picture versions, or “any other form in which a work may
occurred. If first publication took place simultaneously in the United States be recast, transformed, or adapted.” Derivative works also include works
and other countries, it is sufficient to state “U.S.A.” “consisting of editorial revisions, annotations, or other modifications” if these
changes, as a whole, represent an original work of authorship.

4 SPACE 4: Claimant(s) Preexisting Material (space 6a): Complete this space and space 6b for de-
rivative works. In this space identify the preexisting work that has been recast,
transformed, or adapted. For example, the preexisting material might be:
Name(s) and Address(es) of Copyright Claimant(s): Give the name(s) and
“French version of Hugo’s ‘Le Roi s’amuse’.” Do not complete this space for
address(es) of the copyright claimant(s) in this work even if the claimant is the
compilations.
same as the author. Copyright in a work belongs initially to the author of the
work (including, in the case of a work made for hire, the employer or other Material Added to This Work (space 6b): Give a brief, general statement of
person for whom the work was prepared). The copyright claimant is either the the additional new material covered by the copyright claim for which regis-
author of the work or a person or organization to whom the copyright initially tration is sought. In the case of a derivative work, identify this new material.
belonging to the author has been transferred. Examples: “Arrangement for piano and orchestra”; “Dramatization for televi-
sion”; “New film version”; “Revisions throughout; Act III completely new.” If
Transfer: The statute provides that, if the copyright claimant is not the au-
the work is a compilation, give a brief, general statement describing both the
thor, the application for registration must contain “a brief statement of how the
material that has been compiled and the compilation itself. Example: “Com-
claimant obtained ownership of the copyright.” If any copyright claimant
pilation of 19th Century Military Songs.”
named in space 4 is not an author named in space 2, give a brief statement ex-
plaining how the claimant(s) obtained ownership of the copyright. Examples:
“By written contract”; “Transfer of all rights by author”; “Assignment”; “By
will.” Do not attach transfer documents or other attachments or riders. 7,8,9 SPACE 7, 8, 9: Fee, Correspondence,
Certification, Return Address

5 SPACE 5: Previous Registration Deposit Account: If you maintain a Deposit Account in the Copyright Of-
fice, identify it in space 7. Otherwise leave the space blank and send the fee of
$20 with your application and deposit.
General Instructions: The questions in space 5 are intended to show
whether an earlier registration has been made for this work and, if so, whether Correspondence (space 7): This space should contain the name, address,
there is any basis for a new registration. As a general rule, only one basic copy- area code, and telephone number of the person to be consulted if correspon-
right registration can be made for the same version of a particular work. dence about this application becomes necessary.
Same Version: If this version is substantially the same as the work covered Certification (space 8): The application cannot be accepted unless it bears
by a previous registration, a second registration is not generally possible un- the date and the handwritten signature of the author or other copyright claim-
less: (1) the work has been registered in unpublished form and a second regis- ant, or of the owner of exclusive right(s), or of the duly authorized agent of the
tration is now being sought to cover this first published edition; or (2) someone author, claimant, or owner of exclusive right(s).
other than the author is identified as copyright claimant in the earlier registra-
tion, and the author is now seeking registration in his or her own name. If ei- Address for Return of Certificate (space 9): The address box must be com-
ther of these two exceptions apply, check the appropriate box and give the ear- pleted legibly since the certificate will be returned in a window envelope.
lier registration number and date. Otherwise, do not submit Form PA; instead,
write the Copyright Office for information about supplementary registration
or recordation of transfers of copyright ownership.

MORE INFORMATION
(3) File Form SR if you are seeking to register the “sound recording” itself, that is, the
How to Register a Recorded Work: If the musical or dramatic work work that results from the fixation of a series of musical, spoken, or other sounds, but not
that you are registering has been recorded (as a tape, disk, or cassette), you may choose the underlying musical or dramatic work.
either copyright application Form PA (Performing Arts) or Form SR (Sound Recordings),
depending on the purpose of the registration. (4) File Form SR if you are the copyright claimant for both the underlying musical or
Form PA should be used to register the underlying musical composition or dramatic dramatic work and the sound recording, and you prefer to register both on the same form.
work. Form SR has been developed specifically to register a “sound recording” as defined (5) File both forms PA and SR if the copyright claimant for the underlying work and
by the Copyright Act—a work resulting from the “fixation of a series of sounds,” separate sound recording differ, or you prefer to have separate registration for them.
and distinct from the underlying musical or dramatic work. Form SR should be used
when the copyright claim is limited to the sound recording itself. (In one instance, Form
SR may also be used to file for a copyright registration for both kinds of works—see (4) “Copies” and “Phonorecords”: To register for copyright, you are re-
below.) Therefore: quired to deposit “copies” or “phonorecords.” These are defined as follows:
(1) File Form PA if you are seeking to register the musical or dramatic work, not the Musical compositions may be embodied (fixed) in “copies,” objects from which a work
“sound recording,” even though what you deposit for copyright purposes may be in the can be read or visually perceived, directly or with the aid of a machine or device, such as
form of a phonorecord. manuscripts, books, sheet music, film, and videotape. They may also be fixed in
“phonorecords,” objects embodying fixations of sounds, such as tapes and phonograph
(2) File Form PA if you are seeking to register the audio portion of an audiovisual disks, commonly known as phonograph records. For example, a song (the work to be
work, such as a motion picture soundtrack; these are considered integral parts of the au- registered) can be reproduced in sheet music (“copies”) or phonograph records
diovisual work. (“phonorecords”), or both.
 FORM PA
For a Work of the Performing Arts
UNITED STATES COPYRIGHT OFFICE
REGISTRATION NUMBER

PA PAU
EFFECTIVE DATE OF REGISTRATION

Month Day Year

DO NOT WRITE ABOVE THIS LINE. IF YOU NEED MORE SPACE, USE A SEPARATE CONTINUATION SHEET.

1
TITLE OF THIS WORK ▼

PREVIOUS OR ALTERNATIVE TITLES ▼

NATURE OF THIS WORK ▼ See instructions

NAME OF AUTHOR ▼

2
DATES OF BIRTH AND DEATH

a Was this contribution to the work a

Year Born ▼ Year Died ▼

AUTHOR'S NATIONALITY OR DOMICILE WAS THIS AUTHOR'S CONTRIBUTION TO

“work made for hire”? Name of Country THE WORK If the answer to either

{ of these questions is
▼

M Yes OR Citizen of Anonymous? M Yes M No “Yes,” see detailed

▼

M No Domiciled in Pseudonymous? M Yes M No instructions.

NATURE OF AUTHORSHIP Briefly describe nature of material created by this author in which copyright is claimed. ▼
NOTE
Under the law, NAME OF AUTHOR ▼ DATES OF BIRTH AND DEATH
the “author” of
a “work made
for hire” is
generally the
b Year Born ▼ Year Died ▼

Was this contribution to the work a AUTHOR'S NATIONALITY OR DOMICILE WAS THIS AUTHOR'S CONTRIBUTION TO
employer, not Name of Country THE WORK If the answer to either
“work made for hire”?
the employee

{ of these questions is
▼

(see instruc- M Yes Citizen of Anonymous? M Yes M No

OR “Yes,” see detailed
tions). For any
M No
▼

Domiciled in Pseudonymous? M Yes M No instructions.

part of this
work that was NATURE OF AUTHORSHIP Briefly describe nature of material created by this author in which copyright is claimed. ▼
“made for hire”
check “Yes” in
the space
provided, give NAME OF AUTHOR ▼ DATES OF BIRTH AND DEATH
the employer
(or other
person for
c Year Born ▼ Year Died ▼

whom the work Was this contribution to the work a AUTHOR'S NATIONALITY OR DOMICILE WAS THIS AUTHOR'S CONTRIBUTION TO
was prepared) “work made for hire”? Name of Country THE WORK If the answer to either
as “Author” of
{ of these questions is
▼

that part, and M Yes OR Citizen of Anonymous? M Yes M No “Yes,” see detailed
▼

leave the M No Domiciled in Pseudonymous? M Yes M No instructions.

space for dates
of birth and NATURE OF AUTHORSHIP Briefly describe nature of material created by this author in which copyright is claimed. ▼
death blank.

3
YEAR IN WHICH CREATION OF THIS DATE AND NATION OF FIRST PUBLICATION OF THIS PARTICULAR WORK

a WORK WAS COMPLETED This information

b
▼

Complete this information Month Day Year

must be given ONLY if this work
▲

Year in all cases. has been published. Nation

APPLICATION RECEIVED

4
COPYRIGHT CLAIMANT(S) Name and address must be given even if the claimant is the same as
the author given in space 2. ▼
DO NOT WRITE HERE

ONE DEPOSIT RECEIVED

OFFICE USE ONLY

See instructions
before completing TWO DEPOSITS RECEIVED
this space.
TRANSFER If the claimant(s) named here in space 4 is (are) different from the author(s) named in
space 2, give a brief statement of how the claimant(s) obtained ownership of the copyright. ▼ FUNDS RECEIVED

MORE ON BACK
▼

• Complete all applicable spaces (numbers 5-9) on the reverse side of this page. DO NOT WRITE HERE
• See detailed instructions. • Sign the form at line 8.
Page 1 of pages
 EXAMINED BY FORM PA

CHECKED BY

FOR
CORRESPONDENCE
■ Yes
COPYRIGHT
OFFICE
USE
ONLY

DO NOT WRITE ABOVE THIS LINE. IF YOU NEED MORE SPACE, USE A SEPARATE CONTINUATION SHEET.
PREVIOUS REGISTRATION Has registration for this work, or for an earlier version of this work, already been made in the Copyright Office?
M Yes M No If your answer is “Yes,” why is another registration being sought? (Check appropriate box) ▼
a. M This is the first published edition of a work previously registered in unpublished form.
b. M This is the first application submitted by this author as copyright claimant.
c. M This is a changed version of the work, as shown by space 6 on this application.
5
If your answer is “Yes,” give: Previous Registration Number ▼ Year of Registration ▼

DERIVATIVE WORK OR COMPILATION Complete both space 6a and 6b for a derivative work; complete only 6b for a compilation.
a. Preexisting Material Identify any preexisting work or works that this work is based on or incorporates. ▼

6
See instructions
before completing
this space.
b. Material Added to This Work Give a brief, general statement of the material that has been added to this work and in which copyright is claimed. ▼

7
DEPOSIT ACCOUNT If the registration fee is to be charged to a Deposit Account established in the Copyright Office, give name and number of Account.
Name ▼ Account Number ▼

CORRESPONDENCE Give name and address to which correspondence about this application should be sent. Name/Address/Apt/City/State/ZIP ▼

Be sure to
give your
daytime phone

▲
▼

Area Code and Telephone Number number

8
CERTIFICATION* I, the undersigned, hereby certify that I am the
Check only one ▼
M author
M other copyright claimant
M owner of exclusive right(s)
M authorized agent of
Name of author or other copyright claimant, or owner of exclusive right(s) ▲

of the work identified in this application and that the statements made
by me in this application are correct to the best of my knowledge.

Typed or printed name and date ▼ If this application gives a date of publication in space 3, do not sign and submit it before that date.
▼

Date

☛ Handwritten signature (X) ▼

9
MAIL YOU MUST:
Name ▼ • Complete all necessary spaces
CERTIFI- • Sign your application in space 8
CATE TO SEND ALL 3 ELEMENTS
IN THE SAME PACKAGE:
Number/Street/Apt ▼ 1. Application form
2. Nonrefundable $20 filing fee
Certificate in check or money order
will be payable to Register of Copyrights
3. Deposit material
mailed in City/State/ZIP ▼
MAIL TO:
window Register of Copyrights
Library of Congress
envelope Washington, D.C. 20559-6000

*17 U.S.C. § 506(e): Any person who knowingly makes a false representation of a material fact in the application for copyright registration provided for by section 409, or in any written statement filed in connection
with the application, shall be fined not more than $2,500.
May 1995—300,000 ✩U.S. COPYRIGHT OFFICE WWW FORM: 1995