Master License Request Please fill out the form below and click 'Submit' Licensee Information Name of Project* Production Company/Network name Contact Name* Street Address* City* State* Zip Code* Country* Email Address* Phone Number * (555-555-5555) Fax Number Track Information Song Title* Artist(s)* Composer(s) Publisher(s) Source Album Terms of Request Advance* (indicate unit of currency) Length of Term(years, months, days) Release Date Territory please be specific Projected Sales(in units) Master Record Use Information Title of your Album/Compilation Rights Requested (check all that apply) Exclusive Non-Exclusive Physical CD/Vinyl Mobile Ringtone Digital Download Streaming Royalty Rate (per-unit)* indicate unit of currency Royalty Rate (based on) PPD Net Receipts Retail Price # of Tracks on Album/Compilation submit
Production Company/Network name
Contact Name*
Street Address*
City*
State*
Zip Code*
Country*
Email Address*
Phone Number * (555-555-5555)
Fax Number
Song Title*
Artist(s)*
Composer(s)
Publisher(s)
Source Album
Advance*
(indicate unit of currency)
Length of Term(years, months, days)
Release Date
Projected Sales(in units)
Title of your
Album/Compilation
Rights Requested
(check all that apply)
Exclusive
Non-Exclusive
Physical CD/Vinyl
Mobile Ringtone
Digital Download
Streaming
Royalty Rate (per-unit)*
indicate unit of currency
# of Tracks on Album/Compilation
submit
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