Fillable Intellectual Property Rights (Ipr) Form printable pdf download

INTELLECTUAL PROPERTY RIGHTS (IPR) FORM

Required for All Sources

Incomplete Information May Delay Your Order

Additional Documentation May Be Required

Letters of Indemnity are not adequate

LICENSED content requires proof of licensing for replication

OWNED content indicates the individual/organization completing this form is the IPR owner

Must be completed by the organization soliciting replication and not by a broker or intermediary

Provide all of the information in the first section:

Company Name: ___________________________ Contact: ___________________________

Project Title: ______________________________ Phone #: ___________________________

What type of media will be replicated? CD-R ___ DVD-R ___ Cassette ___ Other ________

How do you plan to distribute the copies of this project? (Check all that apply)

Within an organization__ Retail__ Distributed for Free__ Other________________________

List the Countries where this will be distributed:_____________________________________

Do you own the Intellectual Property Rights (IPR) for the entire disc contents? Yes__ No__

Complete the section(s) below that describe the content of the media you have ordered.

CD-ROM / DVD-ROM Content

Describe the type of content material: Application__ Database__ Multimedia__ Other__________

Are any contents compressed/encrypted? Yes__ No__

If yes, provide decompression/decryption instructions.

Do you own the IPR for the ROM contents of the disc? Yes__ No__

If you do not own the IPR, list all included non-owned software, freeware, and shareware

products. Attach necessary distribution licensing documentation from the IPR owner.

Some shareware and freeware products require distribution licensing. Consult the software vendor for what is necessary.

CD / DVD / Cassette Audio Content

Describe the type of content material: Compilation__ Single Artist/Band__

Other___________

Describe the type of musical style: Rock__ Rap__ Gospel__ Spoken Word__ Other___________

Artist(s):_________________________________________________________________________

An attached list including Track Title, Artist, and IPR owner is REQUIRED. Sampling/mixing of additional recordings not

owned (regardless of type, quantity, and length) requires licensing of those original recordings.

Do you own the IPR for the Audio contents of the disc/tape? Yes__ No__

*If Not the IPR owner, proof of replication licensing from IPR owner for licensed tracks is REQUIRED.

CD /DVD Video Content

Describe the type of content material: Theatric al__ Promotional__ Documentary__ Other_____

If Audio is separately licensed, complete the Audio section and provide necessary Audio/Video Synchronization licensing.

Do you own the IPR for the Video contents of the disc? Yes__ No__

*If Not the IPR owner, proof of replication licensing from IPR owner is REQUIRED.

I affirm that all information provided herein is true and that all disc contents are properly licensed for duplication/replication under the terms of the original rights holder(s).

Proof of such licensing and/or trademark authorization is attached. I agree to abide by National Audio Company, Inc.’s Terms and Conditions.

National Audio Company, Inc. reserves the right to refuse the processing of any order not complying.

Signed _________________________________________

Date _________________

Print Name _____________________________________

Title______________________________________

MUST BE COMPANY OFFICER

Company Address _______________________________

________________________________________________

Intellectual Property Rights (Ipr) Form

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