To: The Comptroller of Customs

[If this notice relates to more than one work, the details required by this notice can be included in a schedule in the manner as prescribed below]

(a) .................................. , of (b) .................................. , claims that (c) ................. is a work in which (a) .................................. owns the copyright.

• 1.Titles of the work: (d) .................................................................................
• 2.In relation to a literary, dramatic, musical or artistic work that is not computer generated, the full name of the author: (e)
• 3.In relation to a published edition, the full name of the publisher:
• 4.In relation to a literary, dramatic, musical or artistic work that is computer generated or in relation to a sound recording or film, the name of the author: (f)
• 5.In relation to a literary, dramatic, musical or artistic work that is not computer generated or in relation to a sound recording or film, the name of the author if still living: (g)
• 6.In relation to a literary, dramatic, musical or artistic work that is not computer generated or in relation to a sound recording or film, the year of the death of the author: (h)
• 7.In relation to a literary, dramatic, musical or artistic work that is computer generated or in relation to a sound recording or film, the year in which the work was made:
• 8.In relation to sound a recording or film, the year in which the work was made and the year in which the work was made available to the public by an authorised act:
• 9.The country and year of first publication of the work: (i)
• 10.The status of the author or publisher at the time of first publication: (j)

  It is requested that the Comptroller of Customs detain any pirated copy or copies of (c).................................. that are in, or at any time come into control of the Customs.

• 11.Particulars in support of claim that item is a pirated copy (if applicable)

  .................................................................................

  .................................................................................

  .................................................................................

• 12.This notice is valid until (k) .................................................................................

  The business/residential address, postal address, and facsimile number of business/residential address:

  Postal address:

  Facsimile No:

Dated this ................. day of ................. 20 ..

(m) ..................................

Signature.

Note:

• (a)Full name of the owner of the copyright.
• (b)Address of the owner of the copyright.
• (c)Description of the work in which copyright is claimed.
• (d)Full name of the agent.
• (e)If the work is of unknown authorship, insert word to the effect.
• (f)If the work published is unknown, insert the words to the effect. If the publisher is a company, insert the name of the company and the division within the company that produced the work.
• (g)Delete if the work is of unknown authorship or if no author is still living.
• (h)Delete if author is still living or, if the work is a work of joint authorship, if any of the authors is still living. If neither is the case, state the year of death of the author or the last surviving author.
• (i)If there was simultaneous publications in more than one country, state all countries.
• (j)Citizenship and domicile or residence of the author of the work or the publisher of the edition or if the author or publisher is a company, the name of the country where the company is incorporated.
• (k)Insert a period that is no longer than 5 years from the date of the notice or, if the copyright in the work will expire within 5 years from the date of the notice to not more than the period for which the copyright in the work will last.
• (l)Insert name of the owner of the copyright or the authorised agent.
• (m)Signature of the owner or the agent.

The works to which this notice relates are—

• 1.listed below; or
• 2.supplied in an electronic medium as agreed with the Comptroller;
• 3.detailed in some other manner (specify)

  (Delete the options which are not applicable)

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