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2 revisions
CRogers at Oct 25, 2020 04:44 PM

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Page type: Entry form

Item number (top right of entry form):

Date of registration stamp:

Date form completed (next to signature):

Description of work:

Date of Agreement or Assignment:

Names of Parties to Agreement or Assignment:

Name and Place of Abode of Proprietor of Copyright (use commas):

Name and Place of Abode of Author of Work (use commas):

Approximate height of image sample (cm):

Approximate width of image sample (cm):

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