4 Form TX

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 TX for registration of published or before that date should have carried a notice. For works first published on
unpublished nondramatic literary works, excluding periodicals or serial and after March 1, 1989, use of the copyright notice is optional. For more
issues. This class includes a wide variety of works: fiction, nonfiction, information about copyright notice, see Circular 3, Copyright Notice.
poetry, textbooks, reference works, directories, catalogs, advertising copy,
compilations of information, and computer programs. For periodicals For Further Information: To speak to a Copyright Office staff member,
and serials, use Form SE. call (202) 707-3000 or 1-877-476-0778 (toll free). Recorded information
is available 24 hours a day. Order forms and other publications from the
Deposit to Accompany Application: An application for copyright registra- address in space 9 or call the Forms and Publications Hotline at (202) 707-
tion must be accompanied by a deposit consisting of copies or phonorecords 9100. Access and download circulars, certain forms, and other information
representing the entire work for which registration is to be made. The from the Copyright Office website at www.copyright.gov.
following are the general deposit requirements as set forth in the statute:
Unpublished Work: Deposit one complete copy (or phonorecord)
PRIVACY ACT ADVISORY STATEMENT Required by the Privacy Act of 1974 (P.L. 93-579)
Published Work: Deposit two complete copies (or one phonorecord) The authority for requesting this information is title 17 U.S.C. §409 and §410. Furnishing the
of the best edition. requested information is voluntary. But if the information is not furnished, it may be necessary to
delay or refuse registration and you may not be entitled to certain relief, remedies, and benefits
Work First Published Outside the United States: Deposit one complete provided in chapters 4 and 5 of title 17 U.S.C.
The principal uses of the requested information are the establishment and maintenance of a
copy (or phonorecord) of the first foreign edition. public record and the examination of the application for compliance with the registration require-
Contribution to a Collective Work: Deposit one complete copy (or ments of the copyright code.
Other routine uses include public inspection and copying, preparation of public indexes, prepara-
phonorecord) of the best edition of the collective work. tion of public catalogs of copyright registrations, and preparation of search reports upon request.
The Copyright Notice: Before March 1, 1989, the use of copyright no- NOTE: No other advisory statement will be given in connection with this application. Please keep
this statement and refer to it if we communicate with you regarding this application.
tice was mandatory on all published works, and any work first published

LINE-BY-LINE INSTRUCTIONS
Please type or print using black ink. The form is used to produce the certificate.

created the work is its “author.” In the case of a work made for hire, the

1 SPACE 1: Title
Title of This Work: Every work submitted for copyright registra-
statute provides that “the employer or other person for whom the work
was prepared is considered the author.”
What Is a “Work Made for Hire”? A “work made for hire” is defined as
tion must be given a title to identify that particular work. If the copies or (1) “a work prepared by an employee within the scope of his or her em-
phonorecords of the work bear a title or an identifying phrase that could ployment”; or (2) “a work specially ordered or commissioned for use as a
serve as a title, transcribe that wording completely and exactly on the ap- contribution to a collective work, as a part of a motion picture or other
plication. Indexing of the registration and future identification of the work audiovisual work, as a translation, as a supplementary work, as a compila-
will depend on the information you give here. tion, as an instructional text, as a test, as answer material for a test, or as
Previous or Alternative Titles: Complete this space if there are any an atlas, if the parties expressly agree in a written instrument signed by
additional titles for the work under which someone searching for the them that the works shall be considered a work made for hire.” If you have
registration might be likely to look or under which a document pertaining
checked “Yes” to indicate that the work was “made for hire,” you must give
to the work might be recorded.
the full legal name of the employer (or other person for whom the work
Publication as a Contribution: If the work being registered is a contri-
was prepared). You may also include the name of the employee along with
bution to a periodical, serial, or collection, give the title of the contribution
the name of the employer (for example: “Elster Publishing Co., employer
in the “Title of This Work” space. Then, in the line headed “Publication
for hire of John Ferguson”).
as a Contribution,” give information about the collective work in which
the contribution appeared. “Anonymous” or “Pseudonymous” Work: An author’s contribution
to a work is “anonymous” if that author is not identified on the cop-
ies or phonorecords of the work. An author’s contribution to a work is

2 SPACE 2: Author(s) “pseudonymous” if that author is identified on the copies or phonorecords

under a fictitious name. If the work is “anonymous” you may: (1) leave the
line blank; or (2) state “anonymous” on the line; or (3) reveal the author’s
General Instructions: After reading these instructions, decide
who are the “authors” of this work for copyright purposes. Then, unless identity. If the work is “pseudonymous” you may: (1) leave the line blank;
the work is a “collective work,” give the requested information about every or (2) give the pseudonym and identify it as such (for example: “Huntley
“author” who contributed any appreciable amount of copyrightable matter Haverstock, pseudonym”); or (3) reveal the author’s name, making clear
to this version of the work. If you need further space, request Continuation which is the real name and which is the pseudonym (for example, “Judith
Sheets. In the case of a collective work, such as an anthology, collection Barton, whose pseudonym is Madeline Elster”). However, the citizenship
of essays, or encyclopedia, give information about the author of the col- or domicile of the author must be given in all cases.
lective work as a whole. Dates of Birth and Death: If the author is dead, the statute requires
Name of Author: The fullest form of the author’s name should be that the year of death be included in the application unless the work is
given. Unless the work was “made for hire,” the individual who actually anonymous or pseudonymous. The author’s birth date is optional but is
useful as a form of identification. Leave this space blank if the author’s unless: (1) the work has been registered in unpublished form and a second
contribution was a “work made for hire.” registration is now being sought to cover this first published edition; or (2)
Author’s Nationality or Domicile: Give the country of which the someone other than the author is identified as copyright claimant in the
author is a citizen or the country in which the author is domiciled. Na- earlier registration, and the author is now seeking registration in his or her
tionality or domicile must be given in all cases. own name. If either of these two exceptions applies, check the appropriate box
Nature of Authorship: After the words “Nature of Authorship,” give and give the earlier registration number and date. Otherwise, do not submit
a brief general statement of the nature of this particular author’s contri- Form TX. Instead, write the Copyright Office for information about supple-
bution to the work. Examples: “Entire text”; “Coauthor of entire text”; mentary registration or recordation of transfers of copyright ownership.
“Computer program”; “Editorial revisions”; “Compilation and English Changed Version: If the work has been changed and you are now seeking
translation”; “New text.” 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

3
of space 6 in accordance with the instructions below.
SPACE 3: Creation and Publication Previous Registration Number and Date: If more than one previous
registration has been made for the work, give the number and date of the
General Instructions: Do not confuse “creation” with “publica- latest registration.
tion.” Every application for copyright registration must state “the year in

6
which creation of the work was completed.” Give the date and nation of
first publication only if the work has been published. SPACE 6: Derivative Work or Compilation
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 General Instructions: Complete space 6 if this work is a “changed
over a period of time, the part of the work existing in fixed form on a version,” “compilation,” or “derivative work” and if it incorporates one or
particular date constitutes the created work on that date. The date you more earlier works that have already been published or registered for copy-
give here should be the year in which the author completed the particular right or that have fallen into the public domain. A “compilation” is defined
version for which registration is now being sought, even if other versions as “a work formed by the collection and assembling of preexisting materials
exist or if further changes or additions are planned. or of data that are selected, coordinated, or arranged in such a way that
Publication: The statute defines “publication” as “the distribution of the resulting work as a whole constitutes an original work of authorship.”
copies or phonorecords of a work to the public by sale or other transfer of A “derivative work” is “a work based on one or more preexisting works.”
ownership, or by rental, lease, or lending.” A work is also “published” if there Examples of derivative works include translations, fictionalizations, abridg-
has been an “offering to distribute copies or phonorecords to a group of ments, condensations, or “any other form in which a work may be recast,
persons for purposes of further distribution, public performance, or public transformed, or adapted.” Derivative works also include works “consisting
display.” Give the full date (month, day, year) when, and the country where, of editorial revisions, annotations, or other modifications” if these changes,
publication first occurred. If first publication took place simultaneously in as a whole, represent an original work of authorship.
the United States and other countries, it is sufficient to state “U.S.A.” Preexisting Material (space 6a): For derivative works, complete this space
and space 6b. In space 6a identify the preexisting work that has been recast,

4
transformed, or adapted. The preexisting work may be material that has
SPACE 4: Claimant(s) been previously published, previously registered, or that is in the public
domain. An example of preexisting material might be: “Russian version
Name(s) and Address(es) of Copyright Claimant(s): Give the of Goncharov’s ‘Oblomov.’”
name(s) and address(es) of the copyright claimant(s) in this work even Material Added to This Work (space 6b): Give a brief, general statement
if the claimant is the same as the author. Copyright in a work belongs of the new material covered by the copyright claim for which registration
initially to the author of the work (including, in the case of a work made is sought. Derivative work examples include: “Foreword, editing, critical
for hire, the employer or other person for whom the work was prepared). annotations”; “Translation”; “Chapters 11–17.” If the work is a compilation,
The copyright claimant is either the author of the work or a person or describe both the compilation itself and the material that has been compiled.
organization to whom the copyright initially belonging to the author has Example: “Compilation of certain 1917 speeches by Woodrow Wilson.” A
been transferred. work may be both a derivative work and compilation, in which case a sample
Transfer: The statute provides that, if the copyright claimant is not the statement might be: “Compilation and additional new material.”
author, the application for registration must contain “a brief statement

7,8,9
of how the claimant obtained ownership of the copyright.” If any copy-
right claimant named in space 4 is not an author named in space 2, give SPACE 7, 8,9: Fee, Correspondence,
a brief statement explaining how the claimant(s) obtained ownership of Certification, Return Address
the copyright. Examples: “By written contract”; “Transfer of all rights by
author”; “Assignment”; “By will.” Do not attach transfer documents or Deposit Account: If you maintain a Deposit Account in the Copyright
other attachments or riders. Office, identify it in space 7a. Otherwise leave the space blank and send the
fee with your application and deposit.

5
Correspondence (space 7b): Give the name, address, area code, telephone
SPACE 5: Previous Registration number, fax number, and email address (if available) of the person to be
consulted if correspondence about this application becomes necessary.
General Instructions: The questions in space 5 are intended to Certification (space 8): The application cannot be accepted unless it bears
show whether an earlier registration has been made for this work and, the date and the handwritten signature of the author or other copyright
if so, whether there is any basis for a new registration. As a general rule, claimant, or of the owner of exclusive right(s), or of the duly authorized
only one basic copyright registration can be made for the same version agent of author, claimant, or owner of exclusive right(s).
of a particular work. Address for Return of Certificate (space 9): The address box must be
Same Version: If this version is substantially the same as the work cov­ completed legibly because the certificate will be returned in a window
ered by a previous registration, a second registration is not generally possi­ble envelope.
Copyright Office fees are subject to change.
For current fees, check the Copyright Office
website at www.copyright.gov, write the Copy­
3 Form TX For a Nondramatic Literary Work
UNITED STATES COPYRIGHT OFFICE
REGISTRATION NUMBER
right Office, or call (202) 707-3000.
Privacy Act Notice: Sections 408-410 of title 17 of the United States
Code authorize the Copyright Office to collect the personally identifying
information requested on this form in order to process the applica-
tion for copyright registration. By providing this information you are TX TXU
agreeing to routine uses of the information that include publication EFFECTIVE DATE OF REGISTRATION
to give legal notice of your copyright claim as required by 17 U.S.C.
§705. It will appear in the Office’s online catalog. If you do not provide
the information requested, registration may be refused or delayed,
and you may not be entitled to certain relief, remedies, and benefits Month Day Year
under the copyright law.

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 ▼

PUBLICATION AS A CONTRIBUTION If this work was published as a contribution to a periodical, serial, or collection, give information about the
collective work in which the contribution appeared. Title of Collective Work ▼

If published in a periodical or serial give: Volume ▼ Number ▼ Issue Date ▼ On Pages ▼

2
NAME OF AUTHOR ▼ dates of birth and death

a Was this contribution to the work a AUTHOR’S NATIONALITY OR DOMICILE

Year Born ▼ Year Died ▼

WAS THIS AUTHOR’S CONTRIBUTION TO

THE WORK

{
“work made for hire”? Name of Country If the answer to either
❑ Yes Citizen of Anonymous? ❑ Yes ❑ No of these questions is
OR “Yes,” see detailed
❑ No Domiciled in Pseudonymous?   ❑ Yes    ❑ No instructions.

NOTE
Under the law,
NATURE OF AUTHORSHIP Briefly describe nature of material created by this author in which copyright is claimed. ▼

NAME OF AUTHOR ▼ dates of birth and death

b
the “author” of
a “work made Year Born ▼ Year Died ▼
for hire” is
generally the
employer, not
the employee
Was this contribution to the work a AUTHOR’S NATIONALITY OR DOMICILE WAS THIS AUTHOR’S CONTRIBUTION TO
THE WORK

{
“work made for hire”? Name of Country If the answer to either
(see instruc­­-
❑ Yes Citizen of Anonymous? ❑ Yes ❑ No of these questions is
­­t ions). For any
part of this OR “Yes,” see detailed
❑ No Domiciled in Pseudonymous?   ❑ Yes    ❑ No instructions.
work that was
“made for hire”
check “Yes” in
NATURE OF AUTHORSHIP Briefly describe nature of material created by this author in which copyright is claimed. ▼
the space
provided, give
NAME OF AUTHOR ▼ dates of birth and death

c
the employer
(or other Year Born ▼ Year Died ▼
person for
whom the work
was prepared) Was this contribution to the work a AUTHOR'S NATIONALITY OR DOMICILE WAS THIS AUTHOR’S CONTRIBUTION TO

{
as “Author”of “work made for hire”? Name of Country THE WORK If the answer to either
that part, and
❑ Yes Citizen of Anonymous? ❑ Yes ❑ No of these questions is
leave the OR “Yes,” see detailed
space for dates ❑ No Domiciled in Pseudonymous?   ❑ Yes    ❑ No instructions.
of birth and
NATURE OF AUTHORSHIP Briefly describe nature of material created by this author in which copyright is claimed. ▼

3
death blank.

a b
YEAR IN WHICH CREATION OF THIS DATE AND NATION OF FIRST PUBLICATION OF THIS PARTICULAR WORK
WORK WAS COMPLETED This information Complete this information Month Day Year
must be given ONLY if this work

4
Year in all cases. has been published. Nation

COPYRIGHT CLAIMANT(S) Name and address must be given even if the claimant is the same as APPLICATION RECEIVED
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 TX

CHECKED BY

FOR
CORRESPONDENCE
COPYRIGHT
Yes OFFICE
USE
ONLY

5
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?
❑ Yes ❑ No If your answer is “Yes,” why is another registration being sought? (Check appropriate box.) ▼
a. ❑ This is the first published edition of a work previously registered in unpublished form.
b. ❑ This is the first application submitted by this author as copyright claimant.
c. ❑ This is a changed version of the work, as shown by space 6 on this application.
If your answer is “Yes,” give: Previous Registration Number Year of Registration
▼

▼
a
6
DERIVATIVE WORK OR COMPILATION
Preexisting Material Identify any preexisting work or works that this work is based on or incorporates. ▼

See instructions
before completing

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. ▼ this space.

a
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 ▼

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

Area code and daytime telephone number ( ) Fax number ( )

▼

Email

{
▼

8
CERTIFICATION* I, the undersigned, hereby certify that I am the ❑ author
❑ other copyright claimant
Check only one
▼

❑ owner of exclusive right(s)

of the work identified in this application and that the statements made ❑ authorized agent of
by me in this application are correct to the best of my knowledge. Name of author or other copyright claimant, or owner of exclusive right(s) ▲

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 ▼

9
Name ▼ YOU MUST:
Certificate • Complete all necessary spaces
• Sign your application in space 8
will be
SEND ALL 3 ELEMENTS
mailed in Number/Street/Apt ▼ IN THE SAME PACKAGE:
window 1. Application form
2. Nonrefundable filing fee in check or money
envelope order payable to Register of Copyrights
to this City/State/Zip ▼ 3. Deposit material
address: MAIL TO:
Library of Congress
Copyright Office-TX
101 Independence Avenue SE
Washington, DC 20559

*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.

Form TX – Full Reviewed: 07 / 2012 Printed on recycled paper U.S. Government Printing Office: 2012-xxx-xxx/xx,xxx