1802.8 (B) (6) Space G: Certification
Form CA must be submitted by an author, a copyright claimant (including a vested owner in the case of a supplementary registration for a renewal registration), an owner of one or more of the exclusive rights in the work, or a duly authorized agent of one of the foregoing persons. 37 C.F.R. § 202.6 (C).
Before submitting Form CA, the applicant must certify the application on Space G. Specifically, the applicant should provide his or her signature under the heading “Signature,” and his or her first and last name should be typed or printed in the space marked “Typed or Printed Name and Date.”
The applicant should check one of the boxes on Form CA indicating whether he or she is an author of the work, a copyright claimant, or an owner of one or more of the exclusive right(s) in the work. If the applicant is an authorized agent of the author, copyright claimant, or owner of exclusive right(s), the applicant should provide the name of the party he or she represents. Ordinarily, an application will be accepted if two or more of the boxes in space G have been checked, unless there is reason to question the application.
By signing Form CA, the applicant certifies that the information provided in the application is correct to the best of his or her knowledge. In addition, the applicant certifies that he or she reviewed the certificate of registration for the basic registration before the application was submitted. See id. § 202.6 (E) (5).
Knowingly making a false representation of a material fact in an application for supplementary registration, or in any written statement filed in connection with the application, is a crime that is punishable under 17 U.S.C. § 506 (E).