1328

THE NEW ZEALAND GAZETTE.

[No. 32]

FORMS.

NEW ZEALAND.

The Copyright Act, 1913.

APPLICATION FOR REGISTRATION OF COPYRIGHT IN A PUBLISHED ORIGINAL LITERARY, DRAMATIC, MUSICAL, OR ARTISTIC WORK.

(By the author or authors, or his or their assignee, agent, or attorney.)

I [We], [Name of applicant in full], of [Address], [Occupation], hereby make application for the registration of the copyright in a [State whether literary, dramatic, musical, or artistic, as the case may be] work, being a [State whether book, drama, song, painting, work of sculpture, lecture, &c., as the case may be] entitled [Title of work in full, or description sufficient to identify it].

I [We] do hereby declare that the said [literary, dramatic, musical, or artistic, as the case may be] work was first published in [State country of publication] by , at , on the , and that such date was not later than fourteen days (or such further time as is fixed by law) after the date of its first publication elsewhere.

I [We] do further declare that is the author of the said [literary, dramatic, musical, or artistic, as the case may be] work, and that I am [we are] the owner[s] of the copyright therein.

And I [we] make this declaration conscientiously believing the statements contained therein to be true in every particular.

[Signature of Applicant.]

Declared at , this day of , 19 , before me—[Signature of person before whom the declaration is made].

To the Registrar of Copyright, Wellington, New Zealand.

NOTE.—Where the applicant is the assignee from the author the applicant must forward with his application each assignment or instrument by virtue of which he derives his title, with an attested copy thereof.

[Form A1.]

NEW ZEALAND.

The Copyright Act, 1913.

APPLICATION FOR REGISTRATION OF COPYRIGHT IN A PUBLISHED ORIGINAL LITERARY, DRAMATIC, MUSICAL, OR ARTISTIC WORK.

(By a firm.)

I [We], [Name of firm in full], doing business at [Place of business], and composed of the following members [Name of individual members of firm in full], hereby apply for the registration of the copyright in a [State whether literary, dramatic, musical, or artistic, as the case may be] work, being a [State whether book, drama, song, painting, work of sculpture, &c., as the case may be] entitled [Title of work in full, or description sufficient to identify it].

And I [Name in full of member of firm who makes the declaration], a member of the firm of [Name of firm in full], the applicant named herein, declare that the said [State whether literary, dramatic, musical, or artistic, as the case may be] work was first published in [State country of publication] by , at , on the , and that such date was not later than fourteen days (or such further time as is fixed by law) after the date of its first publication elsewhere.

I, the said [Name in full of member of firm who makes the declaration], do further declare that [State the name of the author of the work] is the author of the said [State whether literary, dramatic, musical, or artistic, as the case may be] work, and that the said firm of [Name of firm in full] is the owner of the copyright therein.

[Form A2.]

NEW ZEALAND.

The Copyright Act, 1913.

APPLICATION FOR REGISTRATION OF COPYRIGHT IN A PUBLISHED ORIGINAL LITERARY, DRAMATIC, MUSICAL, OR ARTISTIC WORK.

(By a body corporate.)

THE [Name of company in full], a corporation duly organized under the laws of [Name of State or country under whose laws company is organized], located at [State where company is located], and having an established place of business at [State where place of business is established], hereby applies for the registration of the copyright in a [State whether literary, dramatic, musical, or artistic, as the case may be] work, being a [State whether book, drama, song, painting, work of sculpture, &c., as the case may be] entitled [Title of work in full, or description sufficient to identify it].

And I [Name and address of secretary or other officer authorized to make declaration] declare that the said [State whether literary, dramatic, musical, or artistic, as the case may be] work was first published in [State country of publication] by , at , on , and that such date was not later than fourteen days (or such further time as is fixed by law) after the date of its first publication elsewhere.

I, the said [Name and address of secretary or other officer authorized to make declaration], do further declare that [State name of author of work], the author of the said [State whether literary, dramatic, musical, or artistic, as the case may be] work, and that [Name of company in full] is the owner of the copyright therein.

And I, the said [Name and address of secretary or other officer authorized to make declaration], make this declaration conscientiously believing the statements contained therein to be true in every particular.

[Seal of Company.]

The common seal of [Name of company in full] was hereto affixed in the presence of—[Seal must be affixed with signatures of officers as prescribed by the articles of association of company].

Witness to signature of declarant—

[Signature of Declarant.]

To the Registrar of Copyright, Wellington, New Zealand.

NOTE.—Where the applicant is the assignee from the author the applicant must forward with his application each assignment or instrument by virtue of which he derives his title, with an attested copy thereof.

[Form A3.]

NEW ZEALAND.

The Copyright Act, 1913.

APPLICATION FOR THE REGISTRATION OF COPYRIGHT IN A COLLECTIVE WORK.

(By the owner or owners, or his or their assignee, agent, or attorney.)

I [Name in full, address, and occupation of applicant; if application is made by an agent or attorney evidence of authority to make the application must be furnished] hereby make application for the registration of [my, our, their, or its] copyright in a collective work, being a [State whether encyclopaedia, dictionary, year-book, or similar work] entitled [Title of work in full, or description sufficient to identify it].

I do hereby declare that the said [State whether encyclopaedia, dictionary, year-book, or similar work] was first published in [State country of publication] by , at , on the , and that such date was not later than fourteen days (or such further time as is fixed by law) after the date of its first publication elsewhere.

I do further declare that [Name of owner of collective work] is the owner of the copyright in the said [State whether encyclopaedia, dictionary, year-book, or similar work].

And I make this declaration conscientiously believing the statements contained therein to be true in every particular.

[Signature of Applicant.]

And I, the said [Name in full of member of firm who makes the declaration], make this declaration conscientiously believing the statements contained therein to be true in every particular.

[Signature of person authorized to sign the application.]

Declared at , this day of , 19 , before me—[Signature of person before whom the declaration is made].

To the Registrar of Copyright, Wellington, New Zealand.

NOTE.—Where the applicant is the assignee from the author the applicant must forward with his application each assignment or instrument by virtue of which he derives his title, with an attested copy thereof.