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RECEIPT FOR AUTHOR FOR PRICE OF COPYRIGHT

 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:


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