UGANDA REGISTRATION SERVICES BUREAU THE COPYRIGHT AND NEIGHBOURING RIGHTS REGULATIONS, 2010 FORM 4 APPLICATION FOR REGISTRATION OF ASSIGNMENT OR TRANSFER To: The Registrar of Copyright, Uganda Registration Services Bureau Kampala. PART 1—ASSIGNMENT OR TRANSFER 1. Registration No …………………………………………………………. 2. Title of work …………………………………………………………… Nature or category of work…………………………………………….. A description of the nature of the work ……………………………….. 3. Owner of the copyright or neighbouring rights, present on record (a) Name……………………………………………………………. (b) Address…………………………………………………………… (c) Nationality……………………………………………………… 4. Assignee or transferee (a) Name…………………………………………………………… (b) Address…………………………………………………………… (c) Nationality……………………………………………………… (d) Country of residence or principal place of business …………… 6 Particulars of the instrument, if any, under which the interest is claimed i.e certified copy of assignment or transfer, contract or other document evidencing change of ownership………………………………(specify) 7 Limitations, if any, in the assignment or transfer, i.e. whether or not the assignment or transfer is limited to— (a) some of the assignor's rights; (b) a part of the term of copyright; (c) a specified country or geographical area. Signature of applicant) assignee or transferee or agent………………… FOR OFFICIAL USE Date received ………………………………………………………. 15