Certificate of Registration
Registration Number:
Effective on:_______(date)
Title:_____________________
Title of work:_______________
Authors Name:_________________
Address:__________________
Completion/Publication____________________
Year of completion:____________________
Copyright claimant:_______________
Rights and permission_______________________
Organization name:
Address:
Amount in words:_________________________
Certification__________________________
Authorized Signature:
Dated:
