FORM-I


FORM-I

Notice of Relinquishment of Copyright
[See rule 4]
To,
The Registrar of Copyrights,
Copyright Office,

Boudhik Sampada Bhawan, Plot No. 32,

Sector 14, Dwarka, New Delhi-110075

Phone: 011-25301202
Sir,
In accordance with section 21 of the Copyright Act, 1957 (14 of 1957), I hereby give notice that, with effect from the date of this notice, I do relinquish, to the extent specified in the enclosed affidavit, my rights in the work described in the said affidavit.
Place............
Date...............
Yours faithfully,
............
(Signature)

Form of Affidavit referred to above
I,...................................................................................................................................................of
(full name in block letters)
......................................................................................................................................do hereby or
(address)
Solemnly affirmation state that—
(1) I am the author of the work described in the statement below;
(2) I am the owner of the copyright in the said work to the extent specified in the said statement;
(3) I do hereby relinquish my rights in the said work to the extent specified in the said statement:

STATEMENT
Description of the work:
(a) Class of the work (Literary, Dramatic, Musical, Artistic, Cinematograph Film, Sound Recording).
(b) Title of the work, if any;
(c) Full name, address and nationality of the author;
(d) Language of the work, if any;
(e) Name, address and nationality of the publisher, if any;
(f) Year of first publication, if any;
(g) Country of first publication, if any;
(h) If the copyright in the work is registered under section 45, the Registration number, if known.
2. Rights owned by the deponent on the date of the affidavit.(If the rights are owned jointly with others, state names, addresses and nationalities of the joint owners.)
3. Extent to which rights are relinquished.
4. Remarks, if any.
Place...............
Date................
...............
(Signature)

Solemnly affirmed before me by
...........................................................................................................................................
who is known to me personally/
(name of deponent in block letters) who is identified to me by................................................................................................................................/
(name of identifier in block letters) who is known to me Personally.

Place................
 
Date.................
.......................................
(Signature and seal of the Magistrate)

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