Job #: __________________________________________________________________________
XClient Name: ____________________________________________________________________
XAlbum/Project Title: _____________________________________________
XDistribution: Within the organization ___ Retail ___ Free to public ___ Other ____________________
XCountries Where Distributed: US ___ Canada ___ Other ________________
X1. Are you the intellectual property rights owner
of the entire disc contents, including all software products, recorded audio
tracks and video content? YES ___ NO ___
2. SOFTWARE (CD-ROM, DVD-ROM Content)
Required: If not content owner, please list below all included non-owned software,
freeware and shareware products. Attach necessary distribution licensing from
the content owner. Some shareware and freeware products require distribution
licensing. Consult the software vendor for what is necessary.
Included software products: _____________________________________________________________________________________
_____________________________________________________________________________________
3. AUDIO (CD/DVD Content, including MP3 files)
Required: 1. Attach list (and/or Studio PQ Sheet) containing title, artist and
content owner of each recorded track. 2. If not content owner, provide proof
of replication licensing for the recorded tracks. 3. If sampling/mixing from
additional recordings that are not owned (regardless of type, quantity and length),
provide proof of licensing for those original recordings.
Artists(s): ______________________________ Content/Music Type: __________________
X Are you the owner of all song writing/publishing
rights? YES ___ NO* ___
If No, have you secured or are you actively pursuing those song writing rights?
YES ____ NO ___
4. VIDEO (CD/DVD Content)
Required:
1. If not content owner, provide proof of duplication licensing from content
owner.
2. If audio is separately licensed, provide necessary A/V synchronization licensing.
I affirm that all information provided herein is true and that all disc contents
indicated as being “licensed”
are properly licensed for duplication under the terms of the original rights
holder(s) with proof of such
licensing and/or trademark authorization attached. I affirm that I am the intellectual
property rights
owner for all contents indicated as being “owned” and approve of
duplication. I agree to abide by the
current version of the Anti-Piracy Compliance Program procedures and standards
of the International Recording Media Association (available at www.recordingmedia.org).
The replicator reserves the right
to refuse the processing of any order not complying with the Anti-Piracy Compliance
Program guidelines.
Print organization name and telephone number: X____________________________________
Signature of representative: X_______________________________________________________
Print name, title and date: X__________________________________________________
(Name)
X________________________________________________
X _____________________________
(Title) (Date)