Fill out the proper form to register the using these facts:

1. The work is a sculpture, or painting, movie, play, song or recording
2. You are the author of the above work
3. This is not a work made for hire
4. You used your real name
5. The work was completed May 20, 2020
6. Your first publicly distributed the work on September 15, 2021
7. Make up name of work and contact information

For more information about copyright registration see this site: https://www.copyright.gov/registration/

Author's Nationality or Domicile: Give the country of which the author is a citizen or the country in which the author is domi- ciled. Nationality or domicile must be given in all cases. Nature of Authorship: After the words \"Nature of Authorship.\" give a brief general statement of the nature of this particular author's contribution to the work. Examples: \"Entire text\"; \"Coau- thor of entire text\"; \"Computer program\"; \"Editorial revisions\"; \"Compilation and English translation\"; \"New text.\" El SPACE 3: Creation and Publication General Instructions: Do not confuse \"creation\" with \"publication.\" Everyr application for copyright registration must state \"the year in which creation of the work was completed.\" Give the date and nation of first publication only if the work has been published. Creation: Under the statute, a work is \"created\" when it is fixed in a copy or phonorecord for the first time. Where a work has been prepared over a period oftime, the part ofthe work existing in fixed form on a particular date constitutes the created work on that date. The date you give here should be the year in which the author completed the particular version for which registration is now being sought, even if other versions exist or if further changes or additions are planned. Publication: The statute defines \"publication" as \"the distribu- tion of copies or phonorecords of a work to the public by sale or other transfer ofownership. or by rental. lease, or lending.\" A work is also \"published\" if there has been an \"offering to distribute copies or phonorecords to a group of persons for purposes of further distribution. public performance. or public display.\" Give the full date (month. day, year) when, and the country where, publication first occurred. If first publication took place simultaneously in the United States and other countries, it is sufficient to state \"U.S.A.\" I I SPACE 4: Claimant(s) Name(s) and Address(es) of Copyright Claimant(s): Give the name(s] and address(es) of the copyright claimant(s) in this work even if the claimant is the same as the author. Copyright in a work belongs initially to the author of the work (including, in the case of a work made for hire. the employer or other person for whom the work was prepared). The copyright claimant is either the author of the work or a person or organization to whom the copy- right initially belonging to the author has been transferred. Transfer: The statute provides that, if the copyright claimant is not the author. the application for registration must contain \"a brief statement of how the claimant obtained ownership of the copy- right.\" If any copyright claimant named in space 4 is not an author named in space 2, give a brief statement explaining how the claimant(s) obtained ownership of the copyright. Examples: \"By written contract\"; \"Transfer of all rights by author\"; \"Assignment\"; \"By will.\" Do not attach transfer documents or other attachments or riders. El SPACE 5: Previous Registration General Instructions: The questions in space 5 are in- tended to show whether an earlier registration has been made for this work and. if so. whether there is any basis for a new registra- tion. As a general rule, only one basic copyright registration can be made for the same version of a particular work. Same Version: If this version is substantially the same as the work covered by a previous registration, a second registration is not generally possible unless: (I) the work has been registered in unpublished form and a second registration is now being sought to cover this first published edition; or (2) someone other than the author is identified as copyright claimant in the earlier registra- tion, and the author is now seeking registration in his or her own name. If either of these two exceptions applies. check the appropriate box and give the earlier registration number and date. Otherwise. do not submit Form TX. Instead, write the Copyright Office for infor- mation about supplementary registration or recordation of transfers of copyright ownership. Changed Version: If the work has been changed and you are now seeking registration to coverthe additions or revisions. check the last box in space 5. give the earlier registration number and date. and complete both parts of space 6 in accordance with the instructions below. Previous Registration Number and Date: If more than one previous registration has been made for the work. give the number and date of the latest registration. I a SPACE 6: Derivative Work or Compilation General Instructions: Complete space 6 if this work is a \"changed version," \"compilation.\" or \"derivative work" and if it incorporates one or more earlier works that have already been published or registered for copyright or that have fallen into the public domain. A\"compilation\" is defined as \"a work formed by the collection and assembling of preexisting materials or ofdata that are selected. coordinated. or arranged in such a way that the resulting work as a whole constitutes an original work of authorship.\" A \"derivative work\" is \"a work based on one or more preexisting works.\" Examples of derivative works include translations, fiction- alizations. abridgments. condensations. or \"any other form in which a work may be recast. transformed. or adapted.\" Derivative works also include works \"consisting ofeditorial revisions. annotations. or other modifications\" if these changes, as a whole. represent an original work of authorship. Preexisting Material (space 6a): For derivative works, complete this space and space 6b. In space 6a identify the preexisting work that has been recast, transformed, or adapted. The preexisting work may be material that has been previously published. previously registered, orthat is in the public domain. An example ofpreexisting material might be: \"Russian version of Goncharov's 'Oblomov.\"' Material Added to This Work (space 6b): Give a brief. general statement of the new material covered by the copyright claim for which registration is sought. Derivative work examples include: \"Foreword. editing, critical annotations\"; \"Translation"; \"Chapters 1117." If the work is a compilation, describe both the compilation itself and the material that has been compiled. Example: \"Compila- tion of certain 1913' speeches by Woodrow Wilson.\" A work may be both a derivative work and compilation. in which case a sample statement might be: \"Compilation and additional new material.\" a :E; I SPACE 7, 8,9: Fee, Correspondence, Certication, Return Address Deposit Account: If you maintain a Deposit Account in the Copyright Office, identify it in space 'Ir'a. Otherwise leave the space blank and send the fee with your application and deposit. Correspondence (space 7b): Give the name. address. area code. telephone number. fax number. and email address (if available) of the person to be consulted if correspondence about this application becomes necessary. Certification (space 8): The application cannot be accepted un- less it bears the date and the handwritten signature of the author or other copyright claimant. or of the owner of exclusive right(s). or of the duly authorized agent of author, claimant, or owner of exclusive right(s). Address for Return of Certificate (space 9): The address box must be completed legibly since the certificate will be returned in a window envelope. EXAMINED BY FORM TX CHECKED BY CORRESPONDENCE FOR COPYRIGHT Yes OFFICE USE ONLY DO NOT WRITE ABOVE THIS LINE. IF YOU NEED MORE SPACE, USE A SEPARATE CONTINUATION SHEET PREVIOUS REGISTRATION Has registration for this work, or for an earlier version of this work, already been made in the Copyright Office? Yes No If your answer is "Yes," why is another registration being sought? (Check appropriate box.) V . O This is the first published edition of a work previously registered in unpublished form. 5 b. O This is the first application submitted by this author as copyright claimant . This is a changed version of the work, as shown by space 6 on this application. If your answer is "Yes," give: Previous Registration Number Year of Registration DERIVATIVE WORK OR COMPILATION Preexisting Material Identify any preexisting work or works that this work is based on or incorporates. V a 6 See instructions before completing Material Added to This Work Give a brief, general statement of the material that has been added to this work and in which copyright is claimed. this space. b DEPOSIT ACCOUNT If the registration fee is to be charged to a Deposit Account established in the Copyright Office, give name and number of Account. Name V Account Number a CORRESPONDENCE Give name and address to which correspondence about this application should be sent. Name/ Address/ Apt/City/State/Zip V Area code and daytime telephone number Fax number Email CERTIFICATION* I, the undersigned, hereby certify that I am the author Check only one Oother copyright claimant Downer of exclusive right(s) 8 of the work identified in this application and that the statements made by me in this application are correct to the best of my knowledge. Iauthorized agent of Name of author or other copyright claimant, or owner of exclusive right(s) Typed or printed name and date V If this application gives a date of publication in space 3, do not sign and submit it before that date. Date Handwritten signature YOU MUST: Certificate Name Complete all necessary spaces will be Sign your application in space 8 mailed in SEND ALL 3 9 IN THE SAME PACKAGE window Number/Street/Apt V 1. Application form envelope nrefundable filing fee in check or money order payable to Register of Copyrights to this 3. Deposit material address: City/State/Zip V MAIL TO: dorary of Congress 101 independence Avenue SE Washington, DC 20559-6222 *17 USC $506(e): Any person who knowingly makes a false representation of a material fact in the application for copyright registration provided for by section 409, or in any written statement filed in connection with the application, shall be fined not more than $2,500. Form TX - Full Rev: 11/2006 Pr 16 Print: 11/2006-30,000 Printed on recycled paper U.S. Government Printing Office: 2006-xx-xxx/60,xxx(9 Form TX Detach and read these instructions before completing this form. Make sure all applicable spaces have been lled in before you return this form. When to Use This Form: Use Form TX for registration of published or unpublished nondramatic literary works, excluding periodicals or serial issues. This class includes a wide variety of works: fiction. nonfiction. poetry. textbooks. reference works, directories, catalogs, advertising copy, compilations of information. and computer programs. For periodi- cals and serials, use Form SE. Deposit to Accompany Application: An application for copyright registration must be accompanied by a deposit consisting of copies or phonorecords representing the entire work for which registration is to be made. The following are the general deposit requirements as set forth in the statute: Unpublished Work: Deposit one complete copy (or phonorecord) Published Work: Deposit two complete copies (or one phonorecord) ofthe best edition. Work First Published Outside the United States: Deposit one complete copy (or phonorecord) of the first foreign edition. Contribution to a Collective Work: Deposit one complete copy (or phonorecord) of the best edition of the collective work. The Copyright Notice: Before March 1, 1989, the use of copyright notice was mandatory on all published works, and any work first BASIC INFORMATION published before that date should have carried a notice. For works first published on and after March 1, 1989, use of the copyright notice is optional. For more information about copyright notice. see Circular 3. Copyright Notices. For Further Information: To speak to a Copyright Office staff mem- ber. call (202) 707-3000 (TTY: (2037016737). Recorded information is available 24 hours a day. Order forms and other publications from the address in space 9 or call the Forms and Publications Hotline at (202) TOT-9100. Access and download circulars. forms, and other information from the Copyright Ofce website at wmvcopyriglthgov. PRIVACY ACT ADVISORY STATEMENT Remind by lilo Privacy Act a! 1974 (EL. 93-5!!! The authority torreqiesting this htorrnation is title 17 USC, secs. 409 and 410. Furnishing the remested information is voluntary. But it the information is not furnished, it may be necessary to delay or refuse reglstration and you mayI not be entitled to outain reliet, remedies. and benets pm- vided'rtchap'lers 4and50llitle17 USE. The principal uses at the requested information are the establishment and maintenance at a pubic record and the exam'nation ot the application torcompiance wilhthe registration reqiirements ot the copyright code. Other rout'rre uses include pubic inspection and copying. preparation ot public hoaxes. prepa- ration of pubic catalogs ot copyrigtt registrations, and preparation of search reporls Lpon request. NOTE: No other advisory statement IM'I be gun in connection with this application. Please keep this statement and rotor to it it we communicate with you regarting iris appication LlNE-BY-LINE INSTRUCTIONS Please type or print using black ink. The form is used to produce the certicate. I I SPACE 1:1'Itle Title of This Work: Every work submitted for copyright registration must be given a title to identify that particular work. If the copies or phonorecords of the work bear a title or an identifying phrase that could serve as a title, transcribe that wording completely and exactly on the application. Indexing of the registration and future identification of the work will depend on the information you give here. Previous or Alternative Titles: Complete this space if there are any additional titles for the work under which someone searching for the registration might be likely to look or under which a docu- ment pertaining to the work might be recorded. Publication as a Contribution: If the work being registered is a contribution to a periodical. serial. or collection. give the title of the contribution in the \"Title of This Work\" space. Then, in the line headed \"Publication as a Contribution," give information about the collective work in which the contribution appeared. a SPACE 2: Author(s) General Instructions: After reading these instructions. decide who are the \"authors" of this work for copyright purposes. Then, unless the work is a \"collective work.\" give the requested information about every \"author" who contributed any appreciable amount of copyrightable matter to this version of the work. If you need further space, request Continuation Sheets. In the case of a collective work. such as an anthology, collection of essays, or encyclopedia, give information about the author of the collective work as a whole. Name ofAuthor: The fullest form of the author's name should be given. Unless the work was \"made for hire.\" the individual who actually created the work is its \"author.\" In the case ofa work made for hire, the statute provides that \"the employer or other person for whom the work was prepared is considered the author.\" What Is a \"Work Made for Hire\"? A \"work made for hire\" is defined as (l) \"a work prepared by an employee within the scope of his or her employment\"; or (2) \"a work specially ordered or com- missioned for use as a contribution to a collective work, as a part of a motion picture or other audiovisual work, as a translation. as a supplementary work. as a compilation. as an instructional text. as a test, as answer material for a test. or as an atlas, if the parties expressly agree in a written instrument signed by them that the works shall be considered a work made for hire.\" If you have checked \"Yes\" to indicate that the work was \"made for hire," you must give the full legal name of the employer (or other person for whom the work was prepared). You may also include the name of the employee along with the name of the employer (for example: \"Elster Publishing Co., employer for hire of John Ferguson"). \"Anonymous\" or \"Pseudonymous\" Work: An author's co ntri- bution to a work is \"anonymous\" if that author is not identified on the copies or phonorecords of the work. An author's contribution to a work is \"pseudonymous\" if that author is identified on the copies or phonorecords under a fictitious name. If the work is \"anonymous" you may: (1) leave the line blank; or (2) state \"anonymous" on the line; or (3) reveal the author's identity. If the work is \"pseudonymous\" you may: (1) leave the line blank; or (2) give the pseudonym and identify it as such (for example: \"Huntley Haverstock, pseudonym\"); or (3) reveal the author's name. mak- ing clear which is the real name and which is the pseudonym (for example, \"Judith Barton. whose pseudonym is Madeline Elster"). However, the citizenship or domicile of the author must be given in all cases. Dates of Birth and Death: If the author is dead. the statute requires that the year of death be included in the application unless the work is anonymous or pseudonymous. The author's birth date is optional but is useful as a form of identification. Leave this space blank if the author's contribution was a \"work made for hire." Copyright Office fees are subject to change. C Form TX For current fees, check the Copyright Office For a Nondramatic Literary Work UNITED STATES COPYRIGHT OFFICE website at www.copyright.gov, write the Copy- REGISTRATION NUMBER right Office, or call (202) 707-3000. or best results, fill in the form on-screen and then print it. TX TXU EFFECTIVE DATE OF REGISTRATION Month Day Year DO NOT WRITE ABOVE THIS LINE. IF YOU NEED MORE SPACE, USE A SEPARATE CONTINUATION SHEET. TITLE OF THIS WORK PREVIOUS OR ALTERNATIVE TITLES PUBLICATION AS A CONTRIBUTION If this work was published as a contribution to a periodical, serial, or collection, give information about the collective work in which the contribution appeared. Title of Collective Work V If published in a periodical or serial give: Volume V Number V Issue Date On Pages V NAME OF AUT DATES OF BIRTH AND DEATH 2 Year Born V Year Died V a Was this contribution to the work a AUTHOR'S NATIONALITY OR DOMICILE WAS THIS AUTHOR'S CONTRIBUTION TO "work made for hire"? Name of Country THE WORK If the answer to either Yes OR Citizen of Anonymous? Yes No of these questions is "Yes," see detailed 7 No Domiciled in Pseudonymous? Yes No instructions. NOTE NATURE OF AUTHORSHIP Briefly describe nature of material created by this author in which copyright is claimed. V Under the law, the "author" of E OF AUTHOR DATES OF BIRTH AND DEATH a "work made Year Born V Year Died for hire" is generally the employer, not Was this contribution to the work a AUTHOR'S NATIONALITY OR DOMICILE WAS THIS AUTHOR'S CONTRIBUTION TO the employee "work made for hire"? Name of Country THE WORK If the answer to either (see instruc- tions). For any Yes OR Citizen of Anonymous? Yes No of these questions is "Yes," see detailed part of this No Domiciled in Pseudonymous? Yes No instructions. work that was "made for hire" NATURE OF AUTHORSHIP Briefly describe nature of material created by this author in which copyright is claimed. V check "Yes" in the space provided, give the employer NAME OF AUTHOR DATES OF BIRTH AND DEATH (or other Year Born V Year Died person for whom the work was prepared) Was this contribution to the work a AUTHOR'S NATIONALITY OR DOMICILE WAS THIS AUTHOR'S CONTRIBUTION TO as "Author" of "work made for hire"? Name of Country THE WORK If the answer to either that part, and Yes OR Citizen of Anonymous? of these questions is leave the Yes No "Yes," see detailed space for dates No Domiciled in Pseudonymous? Yes No instructions. of birth and death blank. NATURE OF AUTHORSHIP Briefly describe nature of material created by this author in which copyright is claimed. 3 YEAR IN WHICH CREATION OF THIS DATE AND NATION OF FIRST PUBLICATION OF THIS PARTICULAR WORK a WORK WAS COMPLETED This information Complete this information Month Day Year must be given ONLY if this work Year in all cases. has been published. Nation COPYRIGHT CLAIMANT(S) Name and address must be given even if the claimant is the same as APPLICATION RECEIVED 4 the author given in space 2. V ONE DEPOSIT RECEIVED See instructions before completing OFFICE USE ONLY TWO DEPOSITS RECEIVED this space." TRANSFER If the claimant(s) named here in space 4 is (are) different from the author(s) named in space 2, give a brief statement of how the claimant(s) obtained ownership of the copyright. V FUNDS RECEIVED MORE ON BACK Complete all applicable spaces (numbers 5-9) on the reverse side of this page. DO NOT WRITE HERE See detailed instructions. . Sign the form at line 8. Page 1 of. pages