APRIL 1.] THE NEW ZEALAND GAZETTE. 1329

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 instru-
ment by virtue of which he derives his title, with an attested copy
thereof.

[Form B.

NEW ZEALAND.
The Copyright Act, 1913.

APPLICATION FOR REGISTRATION OF COPYRIGHT IN AN
UNPUBLISHED ORIGINAL LITERARY, DRAMATIC, MUSICAL,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 copy-
right in a [State whether literary, dramatic, musical, or artistic,
as the case may be] work, being a [State whether book, song,
drama, painting, &c., as the case may be] entitled [Title of
work in full, or description sufficient to identify it].

I [We] declare that , is the author of the said
[literary, dramatic, musical, or artistic, as the case may be]
work, and at the time of the making thereof, viz. [Fill in
date of making of the negative in the case of a photograph], was
a British subject [or as the case may be] or resident in [State
country of residence].

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

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

[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 instru-
ment by virtue of which he derives his title, with an attested copy
thereof.

[Form C.

NEW ZEALAND.
The Copyright Act, 1913.

APPLICATION FOR REGISTRATION OF COPYRIGHT IN A PHOTO-
GRAPH.

(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 copy-
right in a photograph entitled [Title of photograph in full,
or description sufficient to identify it].

I [We] declare that [State name of author of work, or the
words I am or we are, as the case requires], of [Here insert
address of author if a person other than the applicant], the
author of the said photograph, and at the time of the
making of the original negative, viz. [Fill in date of the
making of the negative], from which it was directly or in-
directly derived [I or he was, we or they were, a British sub-
ject (or as the case may be) resident in .]

And I [we] do hereby further declare that I am [we are]
the owner of the copyright in the said photograph.

And I [we] make this declaration conscientiously be-
lieving 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 instru-
ment by virtue of which he derives his title,[ with an attested copy
thereof.

[Form C1.

NEW ZEALAND.
The Copyright Act, 1913.

APPLICATION FOR REGISTRATION OF COPYRIGHT IN A PHOTO-
GRAPH.

(By a firm.)

I [WE], [Name of firm in full], doing business at [Place of
business], and composed of the following members [Names of
individual members of firm in full], hereby apply for the
registration of the copyright in a photograph entitled [Title
of photograph in full, or description sufficient to identify it]:

And I [Name in full of member of firm who makes the declara-
tion], a member of the firm of [Name of firm in full], the appli-
cant named herein, declare that [Here insert in full name of
author of photograph], of [Address of author], is the author of
the said photograph, and at the time of the making of the
original negative, viz. [Fill in date of making of negative],
from which it was directly or indirectly derived, was [were]
a British subject [or as the case may be] resident in .

I, the said [Name in full of member of firm who makes the
declaration], do further declare that the said firm of [Name
of firm in full] is the owner of the copyright in the said photo-
graph.

And I, the said [Name in full of member of firm who makes
the declaration], make this declaration conscientiously be-
lieving 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 instru-
ment by virtue of which he derives his title, with an attested copy
thereof.

[Form D.

NEW ZEALAND.
The Copyright Act, 1913.

APPLICATION FOR REGISTRATION OF COPYRIGHT IN A PUB-
LISHED MECHANICAL MUSICAL CONTRIVANCE.

(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 copy-
right in a mechanical musical contrivance, being a [State
whether disc, cylinder, roll, &c., as the case may be] for
mechanically reproducing a musical work entitled [Title of
musical work, and (if necessary) a description sufficient to
identify it] by [Name of the author of the musical work].

The original plate from which the said contrivance was
directly or indirectly derived was made by [Name of maker
of the plate] at [Place where the original plate was made] on
[Date on which the original plate was made].

I declare that the said contrivance was first published in
[Name of country of first publication] by , at ,
on , and that such date was not later than fourteen
days (or such further period 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 mechanical contrivance, 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 par-
ticular.

[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 instru-
ment by virtue of which he derives his title, with an attested copy
thereof.

[Form E.

NEW ZEALAND.
The Copyright Act, 1913.

APPLICATION FOR REGISTRATION OF COPYRIGHT IN AN
UNPUBLISHED MECHANICAL MUSICAL CONTRIVANCE.

(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 mechanical musical contrivance, being a [State whether
disc, cylinder, roll, &c., as the case may be] for mechanically
reproducing a musical work entitled [Title of musical work,
and (if necessary) a description sufficient to identify it] by
[Name of the author of the musical work].

The original plate from which the said contrivance was
directly or indirectly derived was made by [Name of the maker
of the plate] at [Place where the original plate was made] on
[Date on which the original plate was made].

I [We] declare that is the author of the said con-
trivance, and at the time of the making thereof was a British
subject [or as the case may be] [or was resident in .]