Fill and Sign the Copyright Book 497331584 Form

Assignment Copyright to Book including Right to Publish and License Work in Book Form as well as Media other than Book Form Assignment made on the ________________ (date) , by ___________________ (Name of Assignor) of ___________________________________________________ _______________________ (street address, city, state, zip code) , referred to herein as Assignor to and in favor of ______________________ (Name of Assignee) , a corporation organized and existing under the laws of the state of _________________, with its principal office located at ___________________________________________ _______________________________ (street address, city, state, zip code) , referred to herein as Assignee . Whereas, Assignor is the Author and sole copyright holder of a Book entitled ___________________________________________ (Title of Book) , hereinafter called the Work ; and Whereas, Assignor desires to sell to Assignee all rights to the copyright to the Work including the copyright regarding publication in any format including book both hard copy and paperback, audio, and digital (including an e-book format), any other electronic form pursuant to the terms of this Agreement; Now, therefore, for and in consideration of the payment of $______________, the mutual covenants contained in this Assignment, and other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged; Assignor does hereby assigns to Assignee, its successors and assigns, all his interest in the copyright of the Work and in all renewals and extensions of the copyright that may be secured under the laws now or subsequently in force in the United States of America or in any other country. This Assignment includes Copyright No. _________ granted to Assignor by the Register of Copyrights in the Book entitled ________________________________ ( title of book) , which has been assigned Library of Congress Catalog No. __________, with all my literary property, right, title, and interest in and to the Book and all the profit, benefit, and advantage that shall or may arise from printing, publishing, and vending the same. This Assignment also includes all rights to the copyright of the Work in any form, including, but not limited to all copyright rights in and to hard copy and paperback books, audio versions of the Work, and digital versions of the Work (including an e-book format), and any other electronic form of the Work. Witness my signature this the ___________________ (date) . _____________________________ (Printed Name of Assignor) _____________________________ (Signature of Assignor) Acceptance of Assignment The undersigned Assignee accepts the foregoing instrument, subject to all of its terms and conditions. ______________________________ (Name of Assignee) By:_________________________ (P rinted Name & Office in Corporation) ____________________________ (Signature of Officer) (Acknowledgment form may vary by state) STATE OF _____________ COUNTY OF ____________ Personally appeared before me, the undersigned authority in and for the said county and state, on this _____ day of _____________, 20____, within my jurisdiction, the within named ____________________ (Name of Officer) , who acknowledged that he is _______________________ (Name of Office) of ________________________ (Name of Corporation) , a _____________________ (name of state) corporation, and that for and on behalf of the said corporation, and as its act and deed he executed the above and foregoing instrument, after first having been duly authorized by said corporation so to do. ________________________________ NOTARY PUBLIC My Commission Expires: ____________________ State of _____________________ County of ___________________ Personally appeared before me, the undersigned authority in and for the said County and State, on this ____________________ (date) , within my jurisdic tion, the within-named ________________________ (Name of Assignor) , who acknowledged that he executed the above and foregoing instrument. ________________________________ NOTARY PUBLIC My Commission Expires: ____________________