Application for Registration of a Copyright in a Work

Please print. For assistance in completing the form, please refer to the "Assistance" page.

Notice: information entered in this application will be published on the copyright online database that is available for public inspection on cipo's website.

Note: It is the applicant's responsibility to ensure the accuracy of the included information.

1. Title of the work: Enter the title of a single work. Descriptive matter that does not form part of the title should not be included.

________________________________________________________________________

________________________________________________________________________

2. Category of the work: Select the category that best describes the work.

Literary (works consisting of text, i.e. books, pamphlets, computer programs, etc.)

Musical (musical compositions, with or without words)

Artistic (paintings, drawings, maps, sculptures, plans, photographs, etc.)

Dramatic (screenplays, scripts, plays, films, etc.)

3. Publication: Select whether the work is published or unpublished. If the work is published, enter the full date (year, month, day) and the place of first publication.

The work is published The work is unpublished

Date of first publication: ______________(yyyy/mm/dd)

Place of publication:

City/Town _____________________
Prov./State _____________________
Country________________________

4. Owner: Enter the name and address of the owner of the copyright. To add additional owners, please attach a separate sheet.

Family name _____________________ First name _______________________

OR
Name of other legal entity

________________________________________________________________________

Address

________________________________________________________________________

City/Town _____________

Prov./State ____________

Country ____________

Postal/ZIP code ____________

Optional Information:

Telephone (___)_________

Fax (___)_________

E-mail ________________________________

5. Author: Enter the name of the author of the work. Note: The individual who created the work should be named as the author, except in the case of a photograph, where some other legal entity can be named. To add additional authors, please attach a separate sheet.

Family name _____________________ First name _______________________

or

Name of other legal entity

________________________________________________________________________

If deceased, date of author's death: ______________(yyyy/mm/dd)

Optional Information:

Address

________________________________________________________________________

City/Town _____________

Prov./State ___________

Country _______________

Postal/ZIP code ________

6. Declaration:
I/We hereby declare that the applicant is:

the author of the work;

the owner of the copyright in the work;

an assignee of the copyright;

a licensee of copyright.

7. Agent (if applicable): This section is to be completed only if the application is being submitted by an agent acting on behalf of the applicant.

Family name ______________________ First name ___________________

AND/OR

Name of firm ______________________________________

Address

________________________________________________________________________

City/Town _____________

Prov./State ____________

Country ____________

Postal/ZIP code ____________

Optional Information:

Telephone (____)_____________

Fax (____)______________

E-mail ______________________

8. Fee: In accordance with Item 1 of the Tariff of Fees, the prescribed fee is required for each application for registration of a copyright. Payment should be submitted at the same time as the application using CIPO's Fee Payment Form. Please see the "Assistance" page for further details.

All correspondence should be addressed to:
Copyright Office
Canadian Intellectual Property
Office
Industry Canada
Place du Portage I
50 Victoria Street
Gatineau, QC K1A 0C9

Telephone: 1-866-997-1936
Facsimile: 819 953-2476
Internet address: www.cipo.gc.ca/copyrights
E-mail: cipo.contact@ic.gc.ca