Film Development Fund Form
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4YFSC Use Only
FILM DEVELOPMENT FUND
File No. __________________
Date Received ____________
PLEASE COMPLETE ALL INFORMATION REQUESTED AND INCLUDE ALL RELEVANT DOCUMENTATION WITH YOUR
APPLICATION.
__________________________________________________________________________________________________________
TITLE OF PROJECT
__________________________________________________________________________________________________________
LOG LINE (1-2 SENTENCE PROJECT DESCRIPTION)
LEGAL NAME OF
LEGAL NAME OF CO-PRODUCTION COMPANY(IES) AS
PRODUCTION COMPANY ____________________________
APPLICABLE
ATTACH ADDITIONAL PAGE(S) IF REQUIRED
ADDRESS __________________________________________
____________________________________________________
CITY ______________________________________________
ADDRESS __________________________________________
PROV ________
POSTAL CODE _____________________
CITY ______________________________________________
TEL: (_____)______________
FAX: (_____)______________
PROV ________
POSTAL CODE _____________________
EMAIL: _____________________________________________
TEL: (_____)______________
FAX: (_____)______________
WEB ADDRESS _____________________________________
EMAIL: _____________________________________________
WEB ADDRESS _____________________________________
FINANCING FOR THIS PHASE LEGAL
NAME OF COMPANY OR ORGANIZATION
AMOUNT
%
TELEFILM CANADA
$
%
PRODUCTION COMPANY
$
%
CND CO-PRODUCTION COMPANY
$
%
CND BROADCASTER OR DISTRIBUTOR
$
%
OTHER (SPECIFY)
$
%
OTHER (SPECIFY)
$
%
CANADIAN FINANCING FOR THIS PHASE
$
%
FOREIGN CO-PRODUCTION COMPANY
$
%
OTHER
$
%
FOREIGN FINANCING FOR THIS PHASE
$
%
TOTAL FINANCING FOR THIS PHASE
$
%
YG(5320EQ)F4 Rev.02/2015
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