Code of Federal Regulations Title 37. Patents, Trademarks, and Copyrights § 37.201.39—Required Format of Notice to Libraries and Archives of Normal Commercial Exploitation or Availability at Reasonable Price

NLA

☐ Check box if continuation sheets for additional works are attached.

Notice to Libraries and Archives of Normal Commercial Exploitation or Availability at Reasonable Price

1. Title of the work (or, if untitled, a brief description of the work):  __________.

2. Author(s) of the work:  __________.

3. Type of work (e.g. music, motion picture, book, photograph, illustration, map, article in a periodical, painting, sculpture, sound recording, etc.):  __________.

4. Edition, if any (e.g., first edition, second edition, teacher's edition) or version, if any (e.g., orchestral arrangement, English translation of French text). If there is no information available relating to the edition or version of the work, the Notice should state, “No information available”:  __________.

5. Year of first publication:  _____.

6. Year the work first secured federal copyright through publication with notice or registration as an unpublished work:  _____.

7. Copyright renewal registration number (not required for foreign works restored under 17 U.S.C. 104A):  _____.

8. Full legal name of the copyright owner (or the owner of exclusive rights):  _____.

9. The person or entity identified in space #8 owns:

☐ all rights.

☐ the following rights (e.g., the right to reproduce/distribute/publicly display/publicly perform the work or to prepare a derivative work):  _____.

10. Person or entity that the Copyright Office should contact concerning the Notice:

☐ Name:  

☐ Address:  

☐ Telephone:  

☐ Fax number (if any):  

☐ E-mail address (if any):  

11. Person or entity that libraries and archives may contact concerning the work's normal commercial exploitation or availability at a reasonable price:

☐ Name:  

☐ Address:  

☐ Telephone:  

☐ Fax number (if any):  

☐ E-mail address (if any):  

Additional Content (OPTIONAL):

12. Original copyright registration number:  __________

13. Additional information concerning the work's normal commercial exploitation or availability at a reasonable price:  __________

Declaration:

I declare under penalty of perjury under the laws of the United States:

☐ that each work identified in this notice is subject to normal commercial exploitation.

☐ that a copy or phonorecord of each work identified in this notice is available at a reasonable price.

Signature:  

Date:  

☐ Typed or printed name:  

☐ Title: