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Application Process for General Works (Federal Form-TX)
After you complete & submit this application, you will be instructed on how to email 
your work to our secure mail server.

 
Step 1 - Title / Name of Work

Please note that fields required for processing are in RED.  

Title of this Work:
Alternate Title:


                                     STEP 2 - Contribution Information   

Is your work published as a contribution to a periodical, serial, or collection?  If so you'll need to provide the following "contribution" information.

Publication as a Contribution?:

 YES       NO 

If you answered "Yes," please also provide the following:
 
Title of Collective Work:

Volume:

Number:

Issue Date:

On Pages:

STEP 3 - Authors / Claimants 

Unless you are authoring under a "pen name," you'll probably just select "neither" when asked 

about anonymous & pseudonymous classifications 

If there is only one author, complete this first section then proceed to Step 4.

Author 1

First Name of Author: or name of company if "work made for hire"
Middle Name of Author:
Last Name of Author:
Author Birth date: mm/dd/yyyy
Author Death Date: mm/dd/yyyy
Was this work "made for Hire?" YES     NO
Nationality:

Anonymous/ Pseudonymous:

 
Nature of Authorship:

Author 2
First Name of Author: or name of company if "work made for hire"
Middle Name of Author:
Last Name of Author:
Author Birth date: mm/dd/yyyy
Author Death Date: mm/dd/yyyy
Was this work "made for Hire?" YES     NO
Nationality:

Anonymous/ Pseudonymous:

 
Nature of Authorship:

Author 3
First Name of Author: or name of company if "work made for hire"
Middle Name of Author:
Last Name of Author:
Author Birth date: mm/dd/yyyy
Author Death Date: mm/dd/yyyy
Was this work "made for Hire?" YES     NO
Nationality:

Anonymous/ Pseudonymous:

 
Nature of Authorship:

Author 4
First Name of Author: or name of company if "work made for hire"
Middle Name of Author:
Last Name of Author:
Author Birth date: mm/dd/yyyy
Author Death Date: mm/dd/yyyy
Was this work "made for Hire?" YES     NO
Nationality:

Anonymous/ Pseudonymous:

 
Nature of Authorship:

Author 5
First Name of Author: or name of company if "work made for hire"
Middle Name of Author:
Last Name of Author:
Author Birth date: mm/dd/yyyy
Author Death Date: mm/dd/yyyy
Was this work "made for Hire?" YES     NO
Nationality: