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Intellectual
Property Rights Form
To be submitted with every order
• Letters of indemnity are not adequate
• Licensed content requires proof of licensing for replication/duplication
• Owned content indicates the individual/organization completing this form is
the IPR owner
• Must be completed by the organization soliciting replication and not a broker
or intermediary
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Job
#:
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Client
Name:
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Album/Project
Title:
_____________________________________________
Distribution: Within
the organization ___ Retail
___ Free
to public ___ Other ___
Countries
Where Distributed: US
___ Canada
___ Other
________________
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1.
Are you the intellectual property rights owner of
the entire disc contents, including all software
products, recorded audio tracks and video content? YES
___ NO ___
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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:
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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: __________________
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 ___
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4. VIDEO (CD/DVD
Content)
Required:
1. If not content owner, provide proof of replication licensing
from content owner.
2.
If audio is separately licensed, provide
necessary A/V synchronization licensing.
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I affirm that all information provided herein
is true and that all disc contents indicated as being “licensed” are
properly licensed for replication 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 replication.
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:
____________________________________
Signature of representative:
_______________________________________________________
Print name, title and date: _____________________ ________________________________
"CD
& DVD Duplication Services, Equipment and Supplies"
Total Media, Inc. is a U.S. Government
SDVOSB GSA Supplier.
Call us Today! Toll Free: 888-456-DISK
Voice : (727) 723-3090 Fax: (727) 723-3161
21947 US Hwy 19 North, Clearwater, Florida 33765 U.S.A.
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