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instructions for short Form tX
For nondramatic literary works, including fiction and nonfiction, books, short stories, poems, collections of poetry, essays, articles in serials, and computer programs
HoW to CoMPLete sHoRt FoRM tX • Type or print in black ink. • Be clear and legible. • Give only the information requested. Note: You may use a continuation sheet (Form __/CON) tolist individual titles in a collection. Complete Space A and list the individual titles under Space C on the back page. Space B is not applicable to short forms.

use tHis FoRM iF— 1. You are the only author and copyright owner of this work, and 2. The work was not made for hire, and 3. The work is completely new (does not contain a substantial amount of material that has been previously publishedor registered or is in the public domain). If any of the above does not apply, you may register online at www.copyright.gov or use Form TX. Note: Short Form TX is not appropriate for an anonymous author who does not wish to reveal his or her identity.

You must give a title. If there is no title, state “UNTITLED.” If you are registering an unpublished collection, give the collection title youwant to appear in our records (for example: “Joan’s Poems, Volume 1”). Alternative title: If the work is known by two titles, you also may give the second title. If the work has been published as part of a larger work (including a periodical), give the title of that larger work in addition to the title of the contribution.

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Title of This Work

registering a story and are planning to addillustrations later, check only the box for “text.” A “compilation” of terms or of data is a selection, coordination, or arrangement of such information into a chart, directory, or other form. A compilation of previously published or public domain material must be registered using a standard Form TX.

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Name and Address of Author and Owner of the Copyright

Sign the application in black inkand check the appropriate box. The person signing the application should be the author or his/her authorized agent.

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Signature of Author

Give your name and mailing address. You may include your pseudonym followed by “pseud.” Also, give the nation of which you are a citizen or where you have your domicile (i.e., permanent residence). Give daytime phone and fax numbers and email address,if available.

This space is optional. You may give the name and address of the person or organization to contact for permission to use the work. You may also provide phone, fax, or email information.

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Person to Contact for Rights/Permissions

Year of Creation

Give the latest year in which you completed the work you are registering at this time. A work is “created” when it is writtendown, stored in a computer, or otherwise “fixed” in a tangible form.

If the work has been published (i.e., if copies have been distributed to the public), give the complete date of publication (month, day, and year) and the nation where the publication first took place.

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This space must be completed. Your certificate of registration will be mailed in a window envelope to this address.Also, if the Copyright Office needs to contact you, we will write to this address.

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Certificate Will Be Mailed

Publication

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Deposit Account
Complete this space only if you currently maintain a deposit account in the Copyright Office.

Type of Authorship in This Work
Check the box or boxes that describe your authorship in the copy you are sending with the application. Forexample, if you are

MAIL WITH THE FORM
• The filing fee in the form of a check or money order (no cash) payable to Register of Copyrights, and • One or two copies of the work. If the work is unpublished, send one copy. If published, send two copies of the best published edition. (If first published outside the U.S., send one copy either as first published or of the best edition.) Note: Inquire...