Form D
Regulation 12
COPYRIGHT ACT (CAP 51)
Certificate of Registration
The following work, namely..............................................................................
.........................
has been entered in the Register under
Reference No. ...............................................................................in the name of
..........................................................................................................................
as of the .................................................................................................. , 19......
sealed at my direction this........... .................................. ... ................................
...........................................day of ........................................................ , 19........
.Registrar
The Registrar of Copyrights Office,
Victoria
NOTE: Upon any change of ownership of this copyright, or change in address, the Registrar should
be advised AT ONCE.
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