(Publ Ished) / (Unp Ublis Hed) : T.N.L. NO. 24 - (3 Revision)

T.N.L. NO.
24- (3rd Revision)
APPLICATION FOR COPYRIGHT

(Please read instructions carefully before filling blanks.)
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FILI
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(Publ
ished
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(Unp
ublis
hed)
P
A
P
E
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O
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The Director, The National Library, Manila

12, 2015
Date :
October
SIR: I have the honor to apply for the copyright registration of the (a) unpublished (b)
work named herein of which (c) 2 complete copies are herewith deposited compliance
with the provisions of REPUBLIC ACT 8293. The amount of P200.00 for the registration
fee and ten pesos worth of documentary stamp to be affixed to the certificate are also
enclosed. The data required by the rules and regulations of that office are the following:
Published
1. Name and address of copyright owner: Aaron Jed Yumang Tumbali of

#3 Quirino St. Area 1-B Veterans Village, Pasong Tamo, Quezon City
and the Polytechnic University of the Philippines
2. Name of author:
Aaron Jed Yumang Tumbali
3. Country of which the author is a citizen:
Philippines
4. If alien author, state Alien Certificate No. and where domiciled in the
Philippines:
N/A
5. Title of the Work:
Academic Performance in Technology and

Livelihood Education in Relation to Entrepreneurial Intention of Junior
High School Students Among the Religious of the Virgin Mary Schools
at the National Capital Region
6. Class to which the work belongs:
7. If copyright is claimed upon a new matter in a reissued work, state new

matter specifically:
N/A
(Additional chapters by numbers followed by inclusive pages in parenthesis; other more or less short but materials alterations)
8.
(d) Completed (e) Printed or Reproduced in copies on the
day of
5th
October
(Date when the work or its printing was completed)
at
Manila City, NCR
by
( Municipality, Province)
9.
Jurzel Printing Services

(Person or Establishment making the printing or reproduction in copies)
First published or sold to the public in the Philippines on the N/A day of
N/A
(Day the work was placed on sale, sold or publicly distributed)
by
N/A
N/A
(Municipality, Province)
(Person or Establishment)
10. Send certificate of registration to: Aaron Jed Yumang Tumbali/ #3 Quirino St. Area 1-B Veterans
Village, Pasong Tamo, Quezon City
(Name and
address)
11. Unit price if reproduced in copies for sale:

Very
respe
ctfull
y
your
s,
(Sign
ature
of
Appl
icant
)
===========================================================
=====================
Deposit received on ___________________________ Certificate issued on ____________________________
Application received on ________________________ Signed by ____________________________________
Affidavit received on _______________________
Certificate mailed by ___________________________
Fee received PhP _______ O.R. # _______________ Certificate received by __________________________
(Signature of receiver)
Date of Registration _______________________

XXc ________________________________________
===========================================================
=====================
Of the lines marked (a) to (e) use the ones which apply and cross out the lines not used
** The word author embraces a translator, a composer, painter, sculptor or other artists, or a photographer or
a producer of a cinematographic film or publisher of a periodical, or an editor of work without known
authors.
+ In case of periodicals, the title includes the volume and number as well as the date of each issue separately
registered e.g. Philippine Magazine Vol. XXX No. 2, July 1933.
++ See class designations at the bottom of the reverse or back side hereof. A representative may sign the
application under the name of the claimant Accomplish this form in duplicate;
TYPEWRITTEN ONLY
(THIS FORM IS NOT FOR SALE AND MAYBE REPRODUCED)
AFFIDAVIT
(IMPORTANT- This affidavit must be executed by individual -an official of a corporation or firm may act-and must be under the seal of an
officer authorized to administer oaths within the Philippines. In case of published works the execution must be subsequent to the date of publication. The
affiant must fill in the required statements to accord with the fact concerning the work named, and draw pen through statements not intended to be made.)
REPUBLIC OF THE PHILIPPINES
Municipality of
Province or City of
Quezon City
Metro Manila
S.S.
Aaron Jed Yumang Tumbali

I
being duly sworn, depose do solemnly affirm and say:
That I am the (a) person claiming copyright (b) printer who printed (c) duly authorized agent or representative
residing in the Philippines of the claimant of copyright in the Work named herein;
Quezon City
Metro Manila
That (d) I am a resident of the municipality of
Province of
and
(e)
of
claim/s
(Name of claimant if other than affiant)
ownership of copyright in the said work (f) as (g) by assignment (h) by inheritance from the author hereof, that said work is
( i) original, not copied from any work whether published or unpublished (j) a work falling under Sec. 172 of R.A. 8293 of
which consent of the copyright owner has been secured of which 2 complete copies have been deposited, is entitled
Academic Performance in technology and Livelihood Education in Relation to Entrepreneurial Intention of

Title as it appears on the front part or title page (if book)
Junior High School Students Among the Religious of the Virgin mary Schools at the National Capital Region
of the work, edition number if any; authors name if he is different from claimant)
and have been (k) completed (l) printed or reproduced in copies at
Manila City, Metro Manila

Jurzel Printing Services
by
5th
day October, 2015
day of
the work or its printing or reproduction having been completed on the
and the said work was first published or sold to the public in the Philippines on the
at
(same date given in the application)
by
N/A
.
(Municipality; Province)
.
(Name of person in the application)
(Signature of person making affidavit)
October, 2015
Subscribed and sworn to or affirmed before me this
day of
12th
The deponent in the foregoing affidavit exhibited to me his Community Tax Certificate No.
23502495
Issued at the Municipality of
, Province of
Metro Manila
Philippines, on
Manila City
February 2, 2015
.
NOTARIAL
P10.00
Documentary
Stamp
SEAL
Notary Public
My commission expires on Dec. 31,
Doc. No. __________
Page No. __________
Book No. _________
Series of __________
1.
2.
3.
4.
Of the lines number (a) to (1) use the ones which apply and cross out lines not use.
See footnote** on the reverse back side hereof.
In case of periodicals the title includes the volume and number as well as the date of which issue separately registered ;e.g. Philippine Magazine,
Vol. XXX, No. 2 July 1933.
In case of manuscripts or unpublished works, data regarding publication are not involve and the corresponding blanks spaces need only be created out.
CLASS DESIGNATIONS OF COPYRIGHTABLE WORKS UNDER R. A. 8293

(a) Books, Pamphlets, articles and other writings; (b) Periodicals and newspaper; (c) Lectures, sermons, addresses, dissertations for oral
delivery, whether or not reduced in writing or other material form; (d) Letters; (e) Dramatic or dramatico-musical compositions; choreographic works or
entertainment in dumb shows; (f) Musical compositions with or without words; (g) Works of drawing, painting, architecture, sculpture, engraving,
lithography or other works of arts, model or design for works of arts; (h) Original ornamental designs, or models for articles of manufacture, whether or
not registrable as an industrial designs and other works of applied art; (I) Illustrations maps, plans, sketches, charts and three-dimensional works relative to
geography, topography, architecture or science; (j) drawings or plastic works of a scientific or technical character, (k) Photographic works including works
produced by a process analogous to photography, lantern slide; (l) Audiovisual works and cinematographic works produced by a process analogous to
cinematography or any process for making audio-visual recordings; (m) Pictorial illustrations and advertisements; (n) Computer Programs; (o) Other
literary; scholarly, scientific and artistic works; (P) Sound recordings, and (q) Broadcast recordings.

(Publ Ished) / (Unp Ublis Hed) : T.N.L. NO. 24 - (3 Revision)

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T.N.L. NO.

24- (3rd Revision)

APPLICATION FOR COPYRIGHT

The Director, The National Library, Manila

1. Name and address of copyright owner: Aaron Jed Yumang Tumbali of

Academic Performance in Technology and

6. Class to which the work belongs:

7. If copyright is claimed upon a new matter in a reissued work, state new

(d) Completed (e) Printed or Reproduced in copies on the

(Date when the work or its printing was completed)

Manila City, NCR

Jurzel Printing Services

(Day the work was placed on sale, sold or publicly distributed)

11. Unit price if reproduced in copies for sale:

Date of Registration _______________________

Aaron Jed Yumang Tumbali

Academic Performance in technology and Livelihood Education in Relation to Entrepreneurial Intention of

and have been (k) completed (l) printed or reproduced in copies at

Manila City, Metro Manila

Jurzel Printing Services

day October, 2015

the work or its printing or reproduction having been completed on the

(same date given in the application)

(Signature of person making affidavit)

CLASS DESIGNATIONS OF COPYRIGHTABLE WORKS UNDER R. A. 8293

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