Seal of the Board
Signature .........................................
Executive Director,
The Kenya Copyright Board.
FORM NO. CR 8 (r. 12 (3))
THE COPYRIGHT ACT, 2001
THE KENYA COPYRIGHT BOARD
APPLICATION FOR AUTHENTICATION OF A COPYRIGHT WORK UNDER
SECTION 36 (1) OF THE ACT
Name and address of the
manufacturer/producer or sound recording
or audio-visual work
Physical address
Name and address of agent (if any)
Category of copyright work for which
authentication is being sought
Copyright application/registration number
(if any)
Number of copies to which this application
relates
I/We, the applicant(s) identified above, hereby apply for authentication of the above
copyright work under section 36 (1) of the Act and I/we attach a certified copy of the
contract allowing me/us to sell or distribute the said works.
I/We declare that the information given above is true to the best of my/our information,
knowledge or belief.
BEFORE ME
COMMISSIONER FOR OATHS
NOTE: Authentication devices are not transferable.
Dated at …………………… this ………… day of ……………., 20 …..