Read all of the instructions below before completing this form.
When to use this form Use Form TCS to submit notices of
termination to the Copyright Office for recordation under section 203
or 304(c) of the Copyright Act. Use of Form TCS is mandatory, and a
properly completed Form TCS must accompany all notices submitted
to the Office under 17 U.S.C. §§ 203 or 304(c).
When not to use this form Do not use Form TCS when submitting
any other type of document to the Office, such as transfers of
copyright ownership, DMCA online service provider agent
designations, identification of anonymous/pseudonymous authors,
author death statements, visual arts registry statements, shareware
registry statements, or any Licensing Division documents. In addition,
the Office no longer accepts notices of termination for recordation
under section 304(d) because such notices must have been recorded
before October 26, 2019. A copy of a notice that terminated a grant
under section 304(d) may be submitted for recordation as a
document pertaining to copyright under 17 U.S.C. § 205 in
accordance with the Office’s regulations. See 37 C.F.R. § 201.4.
How to use this form Follow these instructions to complete
Form TCS. All fields are required to the extent applicable except
for terminating party email addresses, which are optional. All
information should be typed or printed. Include one completed and
signed Form TCS for each notice being submitted for recordation.
The Office may reject any notice submitted for recordation that is not
accompanied by Form TCS or is accompanied by an incomplete or
improperly prepared Form TCS.
Submission requirements Submit together in the same envelope
or package: (1) a properly prepared Form TCS; (2) the notice
of termination to be recorded; (3) the proper filing fee; and (4)
any additional material being provided in connection with your
submission, such as a statement of service or an additional copy of
this completed form and a self-addressed postage-paid envelope
for a return receipt. Absent special arrangement with the Office,
the Office reserves the right to not process your submission unless all
of the items necessary for processing are received together. Mail your
submission to:
Copyright Office–Notices of Termination
P.O. Box 71537
Washington, DC 20024-1537
Recordation process To be recorded, your submission must comply
with the Copyright Act’s statutory requirements (17 U.S.C. §§ 203 or
304(c)) and the Office’s regulations (37 C.F.R. § 201.10) and
instructions. The Copyright Office will examine, process, and index
the notice of termination in the public record based on the
information you submit to the Office. The Office will rely on the
certifications and information provided on Form TCS and, if
provided, in an accompanying statement of service. The Office will
not necessarily confirm the accuracy of such certifications or
information against the submitted notice. The fact that the Office has
recorded a notice is not a determination by the Office of the notice’s
validity or legal effect. Recordation of a notice of termination by the
Copyright Office is without prejudice to any party claiming that the
legal or formal requirements for effectuating termination (including
the requirements pertaining to service and recordation) have not been
met, including before a court of competent jurisdiction.
Privacy Act Advisory Statement Please review the Privacy Act
notice at the top of the form. The principal uses of the requested
information are the establishment and maintenance of a public
record and the examination of the form for compliance with the
requirements for recordation. Other routine uses include public
inspection and copying, preparation of public indexes, preparation of
public catalogs of recorded documents, and preparation of search
reports upon request.
note: Form TCS will be imaged with the submitted notice as part of
the public record. Please keep a copy of these instructions and the
completed form so that you may refer to them if the Office
communicates with you regarding your submission.
6
Form TCS (Notice of Termination Cover Sheet)
·
Basic Information
Item-by-Item Instructions
Item 1: Title (and registration number) of rst work identied
in notice
This item is used to connect Form TCS and the notice of
termination if they become separated. In addition to the title of the
first work identified in the notice, the original registration number
should be provided if possible and practicable.
Item 2: Total number of additional works and alternate identiers
in notice
Provide the total number of different additional works and
alternate identifiers contained in the notice. The total number of
works and alternate identifiers determines the recordation filing fee.
The first title and/or registration number provided for a particular
work constitutes a work. If a work is identified by more than one
title or registration number, every additional title and registration
number provided beyond the first counts as an alternate identifier
for purposes of this item and in calculating the proper recordation
filing fee. For example, if a notice were to refer to “Harold & Kumar 2
(PAu003086781) a.k.a. Untitled Harold & Kumar sequel a.k.a. Harold
& Kumar Go to Amsterdam,” the first title and registration number
Form TCS, Notice of Termination Cover Sheet ·
(Harold & Kumar 2 (PAu003086781)) would count as one work and
the two alternate titles would count as two alternate identifiers.
If a work is described as being part of a larger work, only the
specific work counts, and not the title and/or registration number for
the larger work. For example, if the notice were to refer to “When You
Wish Upon a Star from Pinocchio,” the title “When You Wish Upon
a Star” would count as one work, but “Pinocchio” would not count
as an additional work or alternate identifier. For more information
about how to calculate works and alternate identifiers, see 37 C.F.R.
§ 201.3(c), 84 Fed. Reg. 29,135 (June 21, 2019), and 85 Fed. Reg. 9,374
(Feb. 19, 2020).
Item 3: Amount of fee calculated Recordation fees are calculated in
accordance with 37 C.F.R. § 201.3(c). For assistance in determining
your fee, use the fee calculator provided at https://www.copyright.gov/
recordation/ and review Calculating Fees for Recording Documents and
Notices of Termination in the Copyright Office, available at https://www.
copyright.gov/circs/circ12a.pdf.
Item 4: Fee enclosed Check the appropriate box. To charge a
Copyright Office deposit account, provide the deposit account
number and name. If paying by check or money order, note that
the Office only accepts domestic money orders and checks payable
through a U.S. bank with American Bankers Association routing
numbers. International and postal money orders are not accepted.
Make the check or money order payable to U.S. Copyright Office.
Item 5: Return receipt requested Check this box to indicate that
you want a return receipt showing that the Office received your
submission. If you check this box, you must also include a second
properly completed copy of Form TCS and a self-addressed postage-
paid envelope. A return receipt confirms the Office’s receipt of the
submission as of the date indicated, but does not establish eligibility
for, or the date of, recordation.
Item 6: Notice of termination being led under Check the box
next to the statutory termination provision that the submitted
notice is being filed under, section 203 or 304(c). Information about
termination, including the differences between these provisions
can be found on the Office’s website at https://www.copyright.gov/
recordation/termination.html.
Item 7: Gap Grant Check this box if the submitted notice is
terminating a gap grant under 37 C.F.R. § 201.10(f)(1)(ii)(C). For more
information about gap grants, see § 2310.3(C)(3) of the Compendium
of U.S. Copyright Office Practices.
Item 8: Eective date of termination Provide the effective date of
termination. Note that the notice of termination must be recorded
with the Office prior to the effective date of termination.
Item 9: Date of service Provide the date of service of the submitted
notice upon the grantee(s)/successor(s)-in-title.
Item 10: Manner of service Describe the manner of service of the
submitted notice upon the grantee(s)/successor(s)-in-title. For example,
“personal service,” “first class mail,” “courier service,” or “email.”
Item 11: Terminating Party List each terminating party and the
nature of such party’s termination interest under section 203 or
304(c). For example, “John Smith (sole author)”; or “Nancy Jones
(author’s executor)”; or “Jane Smith (author’s widow), Mark Smith
(author’s child), Jessica Smith (author’s child), and Richard Smith
(child of author’s deceased child).” Optionally, you may provide an
email address for any terminating party listed. Where an email is
provided, the Office will copy the party on any correspondence sent
to the remitter, for example, to notify the remitter that there are errors
or omissions in the submission or that a certificate of recordation has
been issued.
Item 12: Grantee List each grantee whose rights are being terminated
or such grantee’s successor-in-title. Identify any successor-in-title as
such.
Item 13: Remitter Information and Certications You, the individual
actually submitting this form and the attached notice of termination
to the Copyright Office, provide your contact information and
make the required remitter certifications by signing your name and
dating the form. You may sign the form electronically. The Office
may use this information to contact you about the submission and
will send a numbered copy of the notice as recorded and certificate
of recordation to the provided address if the notice is successfully
recorded. Providing a fax number is optional. If you are not one of
the terminating parties, you must state which terminating party or
parties you are a duly authorized representative of.
Item 14: Notice Certications Make the required notice-related
certifications by having them signed and dated by an appropriate
individual. They can be made either by you (i.e., the remitter
identified in Item 13) or another individual and may be signed
electronically. If someone other than you is making the certifications
in this item, he or she may sign the same copy of page 2 of the form
as you did in Item 13, or he or she may sign a separate copy of page 2
of the form. If someone other than you is making the certifications in
this item, his or her name, title, and organization must be provided.
Additionally, if such individual is not one of the terminating parties,
he or she must state which terminating party or parties he or she is a
duly authorized representative of.
For more information about the Copyright Oce’s recordation
requirements, see 37 C.F.R. § 201.10(f) and 82 Fed. Reg. 52,213
(Nov. 13, 2017).
Privacy Act Notice: Sections 203, 304(c), and 705 of title 17 of the United States
Code authorize the Copyright Oce to collect the personally identifying
information (PII) requested on this form and provided in the document
submitted for recordation or other materials accompanying the submission.
PII is any personal information that can be used to identify, contact, or trace
an individual, such as names, addresses, and telephone numbers. By providing
this information, including, but not limited to, providing it in any document or
other le, you are agreeing to the routine use of it to establish and maintain
a public record, which includes appearing in the Oce’s paper and online
public records and indexes, including the Oce’s online catalog, and in search
reports prepared for the public. If you do not provide the information requested,
recordation may be refused or delayed, and you may not be entitled to certain
relief, remedies, and benets under the copyright law.
Copyright Oce fees are subject to change. For current fees, check the Copyright Oce website at
www.copyright.gov, write the Copy right Oce, or call (202) 707-3000 or 1-877-476-0778 (toll free).
Volume Document
SR#
Date of recordation
(
)
Send to: Copyright Oce–Notices of Termination, P.O. Box 71537, Washington, DC 20024-1537
Form TCS (Notice of Termination Cover Sheet)
6
For Recordation of Notices of Termination under 17 U.S.C. §§ 203 or 304(c)
1 2
DO NOT WRITE ABOVE THIS LINE • SEE INSTRUCTIONS
To the Register of Copyrights: Please record the accompanying notice of termination.
1
Title (and registration number)
of rst work identied in notice
2
Total number of additional works
and alternate identiers in notice
3
Amount of fee calculated $ (Fees are to be calculated in accordance with 37 C.F.R. § 201.3(c))
4
Fee enclosed Check Money Order
Fee authorized to be charged to Copyright Oce deposit account
Deposit account number
Deposit account name
5
Return receipt requested If checked, please enclose a second completed copy of this form and a self-addressed
postage-paid envelope
6
Notice of termination
being led under §203 §304(c)
7
Gap Grant Check if the notice is terminating a gap grant under 37 C.F.R. § 201.10(f)(1)(ii)(C)
8
Eective date of termination
9
Date of service
10
Manner of service
11
Terminating Party
Terminating Party Email
(optional)
12 Grantee
13
Remitter Information
and Certications
(List all grantees or successors-in-title,
and if successors, state that they are
successors.)
(List all terminating parties and the
nature of their termination interests.)
I certify under penalty of perjury under the laws of the United States of America that I have been given
appropriate authority to submit this cover sheet, accompanying notice of termination, and any other enclosed
materials to the U.S. Copyright Oce for recordation, and that all information I have submitted is true,
accurate, and complete to the best of my knowledge, information, and belief, and is provided in good faith.
I understand that any falsication or misrepresentation may subject me to civil or criminal liability.
By signing my name below, I acknowledge that I have read and agree to these conditions.
Signature Date
Name
Title/Organization
Number/Street Apt/Suite
City State Zip
Phone number Fax number
Email
If you are not one of the terminating parties listed above, state which terminating party
or parties you are a duly authorized representative of.
form tcs reviewed: 03/2021 printed on recycled paper 2 2
(You, the individual actually
submitting this form and the
attached notice of termination to
the Copyright Oce, provide your
contact information and make the
required remitter certications by
signing your name. The Oce may
use this information to contact you
about the submission and will send
the certicate of recordation to the
provided address if the notice is
successfully recorded.)
14
Notice Certications I certify under penalty of perjury under the laws of the United States of America that the accompanying notice
of termination is a true, correct, complete, and legible copy of the signed notice of termination as served on the
grantee or successor-in-title.
I understand that any falsication or misrepresentation may subject me to civil or criminal liability.
By signing my name below, I acknowledge that I have read and agree to these conditions.
Signature Date
Certier Information Name
Title/Organization
If the certier is not one of the terminating parties listed above, state which terminating
party or parties the certier is a duly authorized representative of.
(These certications can be made
either by the remitter identied
above or another individual.)
(This information is only required
if an individual other than the
remitter identied above is making
the above certications.)
(Provide email addresses for any listed
terminating parties to be copied on
correspondence sent to the remitter.)
