To the chief executive of the New Zealand Customs Service
[State full name of the owner of the copyright] of [state the address of the owner of the copyright] claims that [describe the work in which copyright is claimed] is a work in which [state full name of the owner of the copyright] owns the copyright.
The title of the work is [state the title under which the work has been published or attach a list of works as a schedule].
The full name of the author is [if the work is of unknown authorship, insert words to that effect. If the author is a company, insert the name of the company, and the division within the company, that produced the work].
In relation to a published edition, the full name of the publisher is [full name].
*The author is still living.
†The year of the death of the author was [state the year of death of the author or the last surviving author].
The year in which the work was made was [date].
In relation to a sound recording or film, the year in which the work was made and the year in which the work was made available to the public by an authorised act was [date].
The country and year of first publication of the work was [state country and year and, if there was simultaneous publication in more than 1 country, state all countries].
The status of the author or publisher at the time of first publication was [state the citizenship and domicile or residence of the author of the work or the publisher of the edition or, if the author or publisher is a company, the name of the country where the company is incorporated].
The chief executive of the New Zealand Customs Service is requested to detain any pirated copies of [describe the work in which copyright is claimed] that are in, or at any time come into, the control of the New Zealand Customs Service.
This notice is in force for the period [insert a period that is not longer than 5 years from the date of the notice or, if the copyright in the work will expire within 5 years from the date of the notice, not longer than the period for which the copyright will last].
| *Delete if the work is of unknown authorship or if no author is still living. |
| †Delete if the author is still living or, if the work is a work of joint authorship, if one of the authors is still living. |
Details of the person and contact address for the service of any notice are:
Name:
Business/residential address:
Postal address:
Telephone No:
Facsimile No:
Email: