AO 121 (Rev. 06/16) TO: Register of Copyrights U.S. Copyright Office 101 Independence Ave. S.E. Washington, D.C. 20559-6000 REPORT ON THE FILING OR DETERMINATION OF AN ACTION OR APPEAL REGARDING A COPYRIGHT In compliance with the provisions of 17 U.S.C. 508, you are hereby advised that a court action or appeal has been filed on the following copyright(s): G ACTION DOCKET NO. PLAINTIFF G APPEAL DATE FILED COURT NAME AND LOCATION DEFENDANT COPYRIGHT REGISTRATION NO. TITLE OF WORK AUTHOR OR WORK 1 2 3 4 5 In the above-entitled case, the following copyright(s) have been included: DATE INCLUDED COPYRIGHT REGISTRATION NO. INCLUDED BY G Amendment 1 2 3 G Answer TITLE OF WORK G Cross Bill G Other Pleading AUTHOR OF WORK . In the above-entitled case, a final decision was rendered on the date entered below. A copy of the order or judgment together with the written opinion, if any, of the court is attached. COPY ATTACHED WRITTEN OPINION ATTACHED DATE RENDERED G Order CLERK G Judgment G Yes (BY) DEPUTY CLERK G No DATE 1) Upon initiation of action, mail copy to Register of Copyrights DISTRIBUTION: 2) Upon filing of document adding copyright(s), mail copy to Register of Copyrights 5) Case File Copy 3) Upon termination of action, mail copy to Register of Copyrights American LegalNet, Inc. www.FormsWorkFlow.com 4) In the event of an appeal, forward copy to Appellate Court