Special Handling Request Form

5 1 A B C U N I T E D STAT E S CO P Y R I G H T O F F I C E Special Handling Request Form application information (required) Title of the Work (as it appears on the application): Name of Author(s) and Claimant(s) (as they appear on the application): Case Number / Service Request Number (if known): 2 3 A B C justification for special handling Pending or Prospective Litigation (required) Contractual/Publishing Deadlines Customs Matter additional information (optional) To facilitate examination and location of your application and deposited materials, please provide as much of the following information as possible: A description of the deposit copy(ies), phonorecords, or identifying material submitted to the Copyright Office: Date the Application was submitted to the Office: Means of submission to the Copyright Office (e.g., by electronic submission, hand delivery, first class mail, registered mail, certified mail, or private courier, etc.): Tracking number (if applicable): If you are requesting special handling for the purpose of currently PENDING litigation, please answer the following: D E Are you (or your client) the Names of the Parties: Name of the Court: Docket Number: Plaintiff or Defendant in the litigation? 4 certification (required) I certify that I am the author, copyright claimant, owner of one or more of the exclusive rights in the work, or the authorized agent of one of these parties. (Signature) (Date) (Email) (Phone) For more information on the eligibility requirements for special handling, please see the Compendium of U.S. Copyright Office Practices, chapter 600, section 623. U. S. Copyright Office 03 / 2017 · Library of Congress · 101 Independence Avenue SE · Washington, DC 20559 · www.copyright.gov American LegalNet, Inc. www.FormsWorkFlow.com