Application for Copyright Clearance of Department of National Defence (DND) Works

Privacy Statement

Provision of the information requested on this form is voluntary. The personal information collected is to be used to respond to your request for copyright clearance on DND works. We may share this information with other government departments if your inquiry relates to these departments. An incomplete form may result in the rejection of your request or a time delay in processing your request. The personal information will be will be protected, used and disclosed in accordance with the Privacy Act. Under this Act, you have the right to access your personal information and request changes to incorrect information. The information will be retained by DND indefinitely until the retention and disposal schedule is determined and then disposed of accordingly.

For assistance in completing this form, please contact us at the coordinates shown on the last page of this form. Please note that this form applies to Department of National Defence works only, and that all fields marked by an asterisk (*) must be completed.

1. Applicant Information

2. Information On The Applicant's Work

Note: If the Department of National Defence material has been revised, a copy of the revised work and the Department of National Defence material must be included with your request.

Paper CD DVD Electronic/Internet Other (Specify below)

Note: Gross Annual Revenue means the total invoice value of sales of products incorporating one or more DND work(s), before deducting for customer discounts, allowances, or returns. If the copyright protected work is used in advertising, the revenue generated by the product(s) with which the advertising is associated would be counted towards the $10,000 threshold.

3. Information On The Department Of National Defence Work

(mm/dd/yyyy)

OR

Include (if applicable) :

4. Additional Information

Questions regarding the completion of this form should be directed to

Intellectual Property Manager
Director Materiel Policy and Procedures (DMPP 8)
National Defence Headquarters
Major General George R. Pearkes Building
101 Colonel By Drive
Ottawa, Ontario, Canada
K1A 0K2
IntellectualProperty-Proprieteintellectuelle@forces.gc.ca


(The completed application will be sent to the e-mail address which you have provided.)