Production Company:
__________________________________________ Telephone: _____________________
Company Address:
____________________________________________ Email:
__________________________
Contact Person: ____________________________________________
Signature:
______________________
Title of Film, Program or
Series: __________________________________ Episode Title / No.: ________________
Estimated Airdate:
____________________________________________ Production Length: ________________
Performance Details (Fill
in all categories that apply):
Television - List Station or
Network: ______________________________ Foreign
Sales - List Country: ______________ Radio - List Station or Network: __________________________________ Foreign Language Title: __________________
Cinema: ____________________________________________________
MT:
Main Title BI: Background
Instrumental VI: Visual Instrumental
ET:
T:
Theme
No. Title Usage Composer(s) Society Publisher Timing
(e.g.
ASCAP, BMI) (Min/sec. Eg.3:25)
____ _______________________ _______
_____________________ _____________
___________ ____________
____
_______________________
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_____________________
_____________ ___________ ____________
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_______________________
_______ _____________________ _____________ ___________
____________
____
_______________________
_______
_____________________
_____________ ___________ ____________
____
_______________________
_______
_____________________ _____________ ___________
____________
____
_______________________
_______
_____________________
_____________ ___________ ____________
____
_______________________
_______
_____________________
_____________ ___________ ____________
Fax to: 1-(718) 597-7708 Or scan & email to: licensing@thesoundllc.com