Form DC To Correct A Design Registration {DC}

037036 035036034 033032031034030 027026036025030 034024031023 022031035030. þ A þ 037036035034 036033032 037031032034030 031027 026025034 024034023023034030 026025036026 034037022031032021034023 026025034 032034023021020033Registration number of the basic registration þ Year of basic registration Name(s) of designer(s) þ Name(s) of owner(s) (if di037erent than designer(s) þ n ) þ þ B þ 030031017036026021031033 036033032 033036026016r034 031027 021033017031rr034017026 021033027031r037036026021031033Please provide the location and nature of the clerical or typographical error, and set forth the incorrect information as it appears in the basic registration and the corrected information.Space number þ þ Space heading or description þ / Incorrect information as it appears: þ Corrected information:Explanation of correction(s) þ þ C þ 017031rr034023f031033032034033017034Give name and address to which correspondence about this application should be sent.Name þ Address þ Phone ( þ þ ) þ Fax ( þ þ ) þ Email þ D þ 032034f031023021026 036017017031016033026If the registration fee is to be charged to a deposit account established in the Copyright O037ce, give name and number of account.Name þ / þ Account number þ / 5 þ Form DCTo Correct a Design Registration037036035034033032 031034030034033031 027026025024023035022021034 026020020035027033registration number American LegalNet, Inc. www.FormsWorkFlow.com U. þ n S. þ Copyright þ O037ce 267 Library þ of þ Congress 267 101 þ Independence þ Avenue þ SE 267 Washington, þ DC þ 20559 267 www.copyright.gov037036035034 033032 þ 035031030027031026031033: 05/2019 þ Printed on recycled paper þ 025. þ 024. 023036030031035022034031022021 020035027022021027022023 036037037027032031: 2019-xxx-xxx þ 017 þ xx,xxx 037036 035036034 033032031034030 027026036025030 034024031023 022031035030. þ E þ 017034r026021027021017036026021031033*I, the undersigned, hereby certify that I am the (check only one) owner of the registered design duly authorized agent of þ / , the owner of the registered design,and that the statements made by me in this application are correct to the best of my knowledge.036035034033032 031030 034030027026036033032 026025024033 þ 032025036033023027022026025036021030033 þ F þ 037036021030021033020 021033027031r037036026021031033Certi036cate will be mailed in window envelope to this address:026025024033026021024020033030 þ n 017 þ n 023036030033033036 þ n 017 þ n 025034036016027036035 þ n 017 þ n 023036025036033 þ n 017 þ n r027034013031016 037016023026:225 þ Complete all necessary spaces225 þ Sign your application in space E023034033032 036030030 034030034037034033026023 021033 026025034 023036037034 f036017035036020034:1 þ Application form2 þ Nonrefundable 036ling fee in check or money order payable to U.S. Copyright O036ce037036021030 026031:Library of CongressCopyright O037ce-VH101 Independence Avenue SEWashington, DC 20559-6000037036035034 þ 036 USC þ 036 033035032031034030 þ 036 027026025024023022021 þ 036 020017016 þ 036 020024023r026 þ 036 016026f016026r026025022024022013017025030 223Whoever knowingly makes a false representation materially a035ecting the rights obtainable under this chapter for the purpose of obtaining registration of a design under this chapter shall pay a penalty of not less than $500 and not more than $1,000, and any rights or privileges that individual may have in the design under this chapter shall be forfeited.224 form dc receivedfunds received dateexamined bycorrespondence þ Yes þ American LegalNet, Inc. www.FormsWorkFlow.com